Individual
STACY ANN LEVERONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
1045 ESTES DR, SANTA ROSA, CA 95409-2637
(415) 233-2612
Mailing address
1045 ESTES DR, SANTA ROSA, CA 95409-2637
(415) 233-2612
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
59081
CA
Other
Enumeration date
05/10/2021
Last updated
05/10/2021
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