Individual
KETTLY GAUCHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 EMERSON AVE, LEVITTOWN, NY 11756-5705
(631) 333-9004
Mailing address
11 EMERSON AVE, LEVITTOWN, NY 11756-5705
(631) 333-9004
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
032097
NY
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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