Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MSG009081 | PA |
NPI | 1013461938 |
---|---|
Provider Name | Mariah Henry |
First Address | York, PA 17402-9001 |
Second Address | York, PA 17403-5151 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2016 |
Last Update Date | 09/08/2016 |