Individual
CORALIE JENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMT, LMT, HHP
Contact information
Practice address
418 AVIATION BLVD STE D, SANTA ROSA, CA 95403-1074
(707) 486-9846
Mailing address
1023 MAXWELL ST, HEALDSBURG, CA 95448-3533
(707) 486-9846
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
225700000X
Massage Therapist
Primary
74620
CA
225700000X
Massage Therapist
—
—
Other
Enumeration date
11/06/2016
Last updated
05/18/2021
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