Individual
JACINTA WHTICOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
821 CLIFF ST, ITHACA, NY 14850-2097
(607) 256-9355
Mailing address
485 RIDGE RD, LANSING, NY 14882-8802
(607) 794-1071
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
030978-1
NY
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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