Individual
MS. LAURIE ANN MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1332 FOREST AVE, STATEN ISLAND, NY 10302-2012
(917) 767-9525
(888) 522-3203
Mailing address
101 DAVIS AVE APT 2, STATEN ISLAND, NY 10310-3224
(917) 767-9525
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
016941
NY
Other
Enumeration date
08/19/2008
Last updated
02/09/2018
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