Individual
KATHLEEN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
608 S OYSTER BAY RD, HICKSVILLE, NY 11801-3528
(516) 931-3222
Mailing address
608 S OYSTER BAY RD, HICKSVILLE, NY 11801-3528
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
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