Individual
KATHLEEN BENEVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
680 STEWART AVE, GARDEN CITY, NY 11530-4708
(516) 398-7877
Mailing address
680 STEWART AVE, GARDEN CITY, NY 11530-4708
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
020169-1
NY
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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