Individual
REBECCA RAE PORSIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
211 OLD LOUDON RD, LATHAM, NY 12110-2938
(518) 203-8939
Mailing address
10 PARK AVE, LATHAM, NY 12110-4125
(518) 203-8939
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
024170
NY
Other
Enumeration date
11/10/2017
Last updated
04/05/2021
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