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Individual

CHANELLE N SIPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
1094 PINEHURST RD, DUNEDIN, FL 34698-5425
(727) 226-7590
Mailing address
1094 PINEHURST RD, DUNEDIN, FL 34698-5425
(727) 226-7590

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA46039
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA46039
MASSAGE
FL
01
MM35514
MASSAGE ESTABLISHMENT
FL
Enumeration date
02/14/2022
Last updated
02/14/2022
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