Individual
MISS JESSICA LYN PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S., L.M.T.
Contact information
Practice address
152 N WELLWOOD AVE, SUITE 5, LINDENHURST, NY 11757-4046
(631) 835-3600
Mailing address
152 N WELLWOOD AVE, SUITE 5, LINDENHURST, NY 11757-4046
(631) 835-3600
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
017797
NY
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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