Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | ||
Y | 225700000X | Massage Therapist | MT115265 | TX |
NPI | 1003495318 |
---|---|
Provider Name | Ying Chen |
First Address | San Antonio, TX 78240-2538 |
Second Address | San Antonio, TX 78240-2538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2021 |
Last Update Date | 05/04/2021 |