Individual
MS. MARCIA TAMARA TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
49 WATSON AVE, EAST ORANGE, NJ 07018-3303
(973) 798-8193
Mailing address
49 WATSON AVE, EAST ORANGE, NJ 07018-3303
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT01270100
NJ
Other
Enumeration date
09/12/2020
Last updated
09/12/2020
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