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Individual

LESLEY A KAVANAUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
97 4TH ST, TROY, NY 12180-3905
(518) 506-9985
Mailing address
97 4TH ST, TROY, NY 12180-3905
(518) 506-9985

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
013412
NY

Other

Enumeration date
09/30/2008
Last updated
09/30/2008
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