Individual
ANDREA L MALECKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3404 S ATLANTIC AVE, NEW SMYRNA BEACH, FL 32169-3626
(386) 405-4820
Mailing address
217 HUBBELL ST, EDGEWATER, FL 32132-1701
(386) 405-4820
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA58870
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA58870
MASSAGE LICENSE # MA58870
FL
Enumeration date
01/18/2011
Last updated
01/18/2011
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