Individual
MRS. MONICA TENAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1915 E ROANOKE DR, BOISE, ID 83712-7528
(208) 340-8425
Mailing address
1915 E ROANOKE DR, BOISE, ID 83712-7528
(208) 340-8425
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-2859
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPTIONAL
OPTIONAL
—
Enumeration date
02/21/2019
Last updated
02/21/2019
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