Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 017480 | NY |
NPI | 1013677285 |
---|---|
Provider Name | Ms. Kristina Hinckson Ms, Bctmb, Lmt, Le |
First Address | Montclair, NJ 07042 |
Second Address | Montclair, NJ 07042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2021 |
Last Update Date | 29/12/2021 |