Individual
MS. KATHARINE FANNON SUMMERLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1304 E 6TH AVE, TALLAHASSEE, FL 32303-6506
(850) 508-4612
(850) 656-5589
Mailing address
1506 TWIN LAKES CIR, TALLAHASSEE, FL 32311-4195
(850) 508-4612
(850) 656-5589
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA40605
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C3746
BLUECROSS / BLUESHIELD
FL
Enumeration date
02/26/2008
Last updated
02/26/2008
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