Individual
SULEIDY BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
580 SALEM ST APT 36, WAKEFIELD, MA 01880-1274
(978) 317-0436
Mailing address
580 SALEM ST APT 36, WAKEFIELD, MA 01880-1274
(978) 317-0436
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11884
MA
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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