Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA 60487438 | WA |
NPI | 1003219023 |
---|---|
Provider Name | Mrs. Sabrina Bianca Krenzelok |
First Address | Kingston, WA 98346-9751 |
Second Address | Silverdale, WA 98383-7811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2014 |
Last Update Date | 04/10/2014 |