Individual
AB HEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4843 BROADWATER DR, SACRAMENTO, CA 95835-1814
(913) 653-7503
Mailing address
4843 BROADWATER DR, SACRAMENTO, CA 95835-1814
(913) 653-7503
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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