Individual
STEFANIE MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
16916 E LAKE DR, LAKEVILLE, MN 55044-6053
(952) 388-9677
Mailing address
16916 E LAKE DR, LAKEVILLE, MN 55044-6053
(952) 388-9677
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
MN
Other
Enumeration date
06/21/2010
Last updated
06/21/2010
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