Individual
KELLEY SHAUGHNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7620 SOUTHERN BLVD, STE 3, BOARDMAN, OH 44512-5667
(330) 965-9330
(330) 965-9308
Mailing address
1397 S CANFIELD NILES RD, UNIT 1, AUSTINTOWN, OH 44515-4084
(330) 953-0129
(330) 953-0650
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.013613-S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33.013613-S
LMT
OH
Enumeration date
11/20/2014
Last updated
11/30/2016
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