Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 008539-1 | NY |
NPI | 1013156082 |
---|---|
Provider Name | Sylvia Noonan |
First Address | Cheektowaga, NY 14225-3848 |
Second Address | Cheektowaga, NY 14225-3848 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2009 |
Last Update Date | 13/02/2009 |