Individual
THAIS DIEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
1530 5TH ST, BERKELEY, CA 94710-1713
(510) 725-1179
Mailing address
1530 5TH ST # A, BERKELEY, CA 94710-1713
(510) 725-1179
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
87690
CA
Other
Enumeration date
09/20/2021
Last updated
09/20/2021
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