Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 15911 | OH |
NPI | 1013406768 |
---|---|
Provider Name | Monique Robinson |
First Address | Mason, OH 45040-6810 |
Second Address | Mason, OH 45040-6810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2018 |
Last Update Date | 08/05/2018 |