Individual
BARBARA THEKLA DE VITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
317 EL CAMINO REAL, # 112, ENCINITAS, CA 92024
(760) 207-4395
Mailing address
317 EL CAMINO REAL, # 112, ENCINITAS, CA 92024
(760) 207-4395
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
HHP 0392
CA
Other
Enumeration date
10/19/2010
Last updated
10/19/2010
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