Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 31020 | CA |
NPI | 1003578865 |
---|---|
Provider Name | Miss Anna Lisa Huff |
First Address | Playa Del Rey, CA 90293-7835 |
Second Address | Playa Del Rey, CA 90293-7835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2021 |
Last Update Date | 08/10/2021 |