Individual
RENAE HAUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 PINE ST STE G, SANDPOINT, ID 83864-1658
(208) 502-0728
Mailing address
515 PINE ST STE G, SANDPOINT, ID 83864-1658
(208) 502-0728
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-4217
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MAS-4217
MASSAGE THERAPY LICENSE
ID
Enumeration date
06/29/2021
Last updated
06/29/2021
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