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Individual

PEARL DAWN FAUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
515 PINE ST STE G, SANDPOINT, ID 83864-1658
(208) 502-0728
(208) 575-8309
Mailing address
515 PINE ST STE G, SANDPOINT, ID 83864-1658
(208) 502-0728
(208) 575-8309

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-4547
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MAS-4547
LICENSE
ID
Enumeration date
10/11/2021
Last updated
10/11/2021
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