Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist |
NPI | 1013342427 |
---|---|
Provider Name | Alexandra Mew |
First Address | Rochester Hills, MI 48309-3755 |
Second Address | Shelby Township, MI 48315-4716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2013 |
Last Update Date | 06/09/2013 |