Individual
JENNY SABINA MODESTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
235 31ST ST N, ST PETERSBURG, FL 33713-1000
(908) 456-5465
Mailing address
4126 23RD AVE N, ST PETERSBURG, FL 33713-3356
(908) 456-5465
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
82911
FL
Other
Enumeration date
05/08/2019
Last updated
05/08/2019
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