Individual
MS. GWEN HAUGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
797 MAYPORT RD, ATLANTIC BCH, FL 32233-3425
(904) 382-1371
Mailing address
797 MAYPORT RD, ATLANTIC BCH, FL 32233-3425
(904) 382-1371
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA50965
FL
225700000X
Massage Therapist
MA51995
FL
Other
Enumeration date
09/23/2009
Last updated
09/23/2009
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