Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 33.022888 | OH |
NPI | 1013591825 |
---|---|
Provider Name | Stephanie Ferris |
First Address | Mount Vernon, OH 43050-1977 |
Second Address | Mount Vernon, OH 43050-1977 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2021 |
Last Update Date | 07/05/2021 |