Individual
JILL LAVILETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
215 BEACH 97TH ST UNIT 2, ROCKAWAY BEACH, NY 11693-1308
(646) 591-9040
Mailing address
215 BEACH 97TH ST UNIT 2, ROCKAWAY BEACH, NY 11693-1308
(646) 591-9040
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
020755
NY
Other
Enumeration date
01/19/2023
Last updated
01/19/2023
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