Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 9371 | MA |
NPI | 1013371178 |
---|---|
Provider Name | Christina Ean Spangler |
First Address | West Roxbury, MA 02132-2824 |
Second Address | Jamaica Plain, MA 02130-2315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2016 |
Last Update Date | 05/04/2016 |