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Individual
SAMANTHA C GIBLIN
Active
Individual
SAMANTHA C GIBLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT# 19906
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19906
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19906
MASSAGE LICENSE
OR
Enumeration date
07/11/2014
Last updated
07/11/2014
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