Individual
SHANA LEE LEVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
281 MAIN ST, NORTHPORT, NY 11768-1771
(631) 922-1834
Mailing address
2705 CANTABILE ST, SEDONA, AZ 86336-4405
(928) 282-5843
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27 013694
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
614226900
DEPARTMENT OF LABOR
—
Enumeration date
06/18/2009
Last updated
06/16/2016
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