Individual
MS. INGRID SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
363 CENTRE ST, NUTLEY, NJ 07110-4706
(201) 702-9936
Mailing address
363 CENTRE ST, NUTLEY, NJ 07110-4706
(201) 702-9936
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT00692400
NJ
Other
Enumeration date
02/05/2016
Last updated
02/05/2016
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