Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MT 038034 | TX |
NPI | 1003149592 |
---|---|
Provider Name | Yolanda Guadiana |
First Address | San Antonio, TX 78216-5829 |
Second Address | San Antonio, TX 78216-5829 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2009 |
Last Update Date | 02/04/2014 |