Individual
MS. MARY E NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAC., LMT
Contact information
Practice address
152 ISLIP AVE, SUITE 23, ISLIP, NY 11751-3225
(631) 277-6767
(631) 277-4311
Mailing address
190 4TH AVE, HOLTSVILLE, NY 11742-2340
(631) 680-2902
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
25-004803
NY
225700000X
Massage Therapist
013931
NY
Other
Enumeration date
05/15/2012
Last updated
11/18/2016
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