Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MT-02885P | AZ |
NPI | 1013233089 |
---|---|
Provider Name | Amanda Jyoti Rawlinson |
First Address | Sedona, AZ 86336-4316 |
Second Address | Sedona, AZ 86336-4316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2010 |
Last Update Date | 15/04/2010 |