Individual
LESLIE MATEUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
5944
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225700000X
MASSAGE THERAPIST
OR
Enumeration date
03/30/2016
Last updated
03/30/2016
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