Individual
KIMBERLY HANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 MAPLE AVE STE 306, ROCKVILLE CENTRE, NY 11570-4267
(516) 639-4925
Mailing address
159-70 HARLEM RIVER DR APT 5E, NEW YORK, NY 10039-1031
(918) 405-6916
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000
—
NY
05
—
CF32405A
—
NY
Enumeration date
12/09/2021
Last updated
12/09/2021
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