Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 1285 | ND |
NPI | 1013280304 |
---|---|
Provider Name | Mrs. Ashley Marie Huebner |
First Address | Fargo, ND 58103-5202 |
Second Address | Fargo, ND 58103-5202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2012 |
Last Update Date | 30/01/2021 |