Individual
KATHERINE R MANCILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1540 NE 191ST ST APT 140, MIAMI, FL 33179-4106
(786) 200-4312
Mailing address
1540 NE 191ST ST APT 100, MIAMI, FL 33179-4135
(786) 200-4312
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
92655
FL
Other
Enumeration date
09/26/2024
Last updated
05/19/2025
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