NPI | 1609103118 |
---|---|
Former Name | HEATHER DAWN BURNETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: NY 022328) |
Additional Taxonomies | 174400000X Specialist (Licence: NY 27022328) |
Enumeration Date | 2009-11-05 |
Last Update Date | 2022-01-20 |