Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 1516 | ND |
NPI | 1003576562 |
---|---|
Provider Name | Miss Alyssa Marie Sinner |
First Address | Moorhead, MN 56560-6720 |
Second Address | West Fargo, ND 58078-8010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2021 |
Last Update Date | 26/12/2021 |