Individual
STEPHANIE J. KELLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
332 JACKSON AVE, SYOSSET, NY 11791-4124
(516) 931-5000
Mailing address
332 JACKSON AVE, SYOSSET, NY 11791-4124
(516) 931-5000
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
019570
NY
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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