Maxine Souvenir, LMT | |
100 Union St Apt 518, Elizabeth, NJ 07202-2171 | |
(347) 422-4370 | |
Not Available |
Full Name | Maxine Souvenir |
---|---|
Gender | Female |
Speciality | Massage Therapist |
Location | 100 Union St Apt 518, Elizabeth, New Jersey |
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790401966 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225700000X | Massage Therapist | 18KT01438900 (New Jersey) | Primary |
Mailing Address | Practice Location Address |
---|---|
Maxine Souvenir, LMT 100 Union St Apt 518, Elizabeth, NJ 07202-2171 Ph: (347) 422-4370 | Maxine Souvenir, LMT 100 Union St Apt 518, Elizabeth, NJ 07202-2171 Ph: (347) 422-4370 |
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