Individual
MS. SANDRA LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CMLDT, MMT
Contact information
Practice address
159 KENILWORTH AVE, STATEN ISLAND, NY 10312-1393
(917) 971-9663
Mailing address
159 KENILWORTH AVE, STATEN ISLAND, NY 10312-1393
(917) 971-9663
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
022541
NY
Other
Enumeration date
03/04/2011
Last updated
01/27/2026
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