Individual
STEPHANIE AMANDA BLAISDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCLMT
Contact information
Practice address
63 KNOTTY PINE LN, CENTERVILLE, MA 02632-2301
(508) 776-2114
Mailing address
63 KNOTTY PINE LN, CENTERVILLE, MA 02632-2301
(508) 776-2114
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2197
MA
Other
Enumeration date
09/20/2013
Last updated
09/20/2013
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