Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA57126 | FL |
NPI | 1003147216 |
---|---|
Provider Name | Mrs. Daniela Sales Long |
First Address | Coral Springs, FL 33067-3101 |
Second Address | Coral Springs, FL 33067-3101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2010 |
Last Update Date | 28/01/2010 |