Individual
MRS. BRIDIE ANN PHELAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
18KT01140800
NJ
225700000X
Massage Therapist
Primary
9449
NY
Other
Enumeration date
09/28/2020
Last updated
10/08/2020
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