Individual
LENNY VALESKA FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 CLIFTON PL APT 3D, BROOKLYN, NY 11238-7218
(929) 732-8829
Mailing address
321 W 125TH ST, NEW YORK, NY 10027-3637
(929) 732-8829
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
032745
NY
Other
Enumeration date
11/18/2021
Last updated
11/18/2021
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