Individual
BLOSSOM BEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
427 11TH ST, BROOKLYN, NY 11215-4307
(646) 250-9325
Mailing address
427 11TH ST, BROOKLYN, NY 11215-4307
(646) 250-9325
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
025933
NY
Other
Enumeration date
06/11/2012
Last updated
06/11/2012
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