Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MSG001282 | PA |
NPI | 1013254010 |
---|---|
Provider Name | Miss Jennifer Nicole Cesari |
First Address | Philadelphia, PA 19116-3671 |
Second Address | Philadelphia, PA 19125-3707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2013 |
Last Update Date | 05/05/2014 |