Organization
SACRED SOUL WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY TAFT PHD (EXECUTIVE DIRECTOR)
(334) 333-1632
Entity
Organization
Contact information
Practice address
3576 QUAD PKWY, MONTGOMERY, AL 36116-6750
(334) 333-1632
(334) 621-1842
Mailing address
3576 QUAD PKWY, MONTGOMERY, AL 36116-6750
(334) 333-1632
(334) 621-1842
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174016471
INDIVIDUAL
—
Enumeration date
08/05/2019
Last updated
09/21/2021
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