Individual
NANCY ANNE HAGENMAYER-LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
39 KELLAM RD, EQUINUNK, PA 18417-3041
(516) 330-6164
Mailing address
39 KELLAM RD, EQUINUNK, PA 18417-3041
(516) 330-6164
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
005961-1
NY
225700000X
Massage Therapist
Primary
MSG011900
PA
Other
Enumeration date
09/29/2023
Last updated
09/29/2023
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