Individual
MELISSA ANN MORENCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
23505 COUNTY ROAD 19, EXCELSIOR, MN 55331
(952) 470-8555
Mailing address
23505 COUNTY ROAD 19, EXCELSIOR, MN 55331
(952) 470-8555
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
411965436
—
MN
Enumeration date
06/11/2018
Last updated
06/16/2018
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