Individual
DORA JOY MARCINKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
15436 VALERIO ST, VAN NUYS, CA 91406-3326
(818) 606-4073
Mailing address
15436 VALERIO ST, VAN NUYS, CA 91406-3326
(818) 606-4073
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5344
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5344
CAMTC
CA
Enumeration date
07/13/2022
Last updated
07/13/2022
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