Individual
MS. MORGYN DANAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPT, LMT
Contact information
Practice address
12 REVERE ST, PORTLAND, ME 04103-4410
(828) 216-8125
Mailing address
12 REVERE ST, PORTLAND, ME 04103-4410
(828) 216-8125
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT 3746
ME
Other
Enumeration date
11/11/2014
Last updated
11/11/2014
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