Individual
MICHELLE ANGELICA TATIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 NORDHOFF PL STE 26, ENGLEWOOD, NJ 07631-4811
(929) 499-5110
Mailing address
520 CLIFF ST APT 405, FAIRVIEW, NJ 07022-2437
(929) 499-5110
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT00343100
NJ
246Z00000X
Other Specialist/Technologist
—
—
Other
Enumeration date
06/29/2023
Last updated
09/27/2024
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