Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MT138 | ME |
NPI | 1013176049 |
---|---|
Provider Name | Ms. Kathleen M Ocean |
First Address | Waldoboro, ME 04572-0625 |
Second Address | Waldoboro, ME 04572 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2008 |
Last Update Date | 05/06/2008 |