Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 012250 | NY |
NPI | 1013239656 |
---|---|
Provider Name | Helenann Marie Dean |
First Address | Rocky Point, NY 11778-9740 |
Second Address | Rocky Point, NY 11778-9740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2010 |
Last Update Date | 24/02/2010 |