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Individual
MISS LEA ANGELICA MAYANGAO
Active
Individual
MISS LEA ANGELICA MAYANGAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPY
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
043284
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M09534507453922
STATE ID
NJ
Enumeration date
11/12/2018
Last updated
03/26/2019
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