Widlyne Desir
Massage Therapist in Minneapolis, MN. Individual provider (NPI-1).
NPI number1003554148
StatusActive
Last updated in NPPESJul 20, 2024
Details
- NPI
- 1003554148
- Entity type
- Individual (NPI-1)
- Name
- Widlyne Desir
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 26, 2022
- Certification date
- Jul 20, 2024
- Last updated
- Jul 20, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | – | MN | Yes |
| 374J00000X | Doula | – | – |
Practice location
1121 Jackson St Ne Ste 100Minneapolis, MN 55413-3051
Phone 612-405-5876
Mailing address
Po Box 6836Saint Paul, MN 55106-0836
Phone 612-405-5876
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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