Individual
LIDETE BEKELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
50 GALESI DR STE 8, WAYNE, NJ 07470-4842
(201) 673-2295
Mailing address
50 GALESI DR STE 8, WAYNE, NJ 07470-4842
(201) 673-2295
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT00967500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18KT00967500
LICENSE NUMBER
NJ
Enumeration date
12/18/2019
Last updated
12/18/2019
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