Individual
ELYSE THAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
59 E STATE ST, SHERBURNE, NY 13460-9789
(315) 399-7656
Mailing address
59 E STATE ST, SHERBURNE, NY 13460-9789
(315) 399-7656
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27029730
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27029730
MASSAGE LICENSE
NY
Enumeration date
11/22/2016
Last updated
06/02/2025
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