Viviana Baeza Nunez
Massage Therapist in Boise, ID. Individual provider (NPI-1).
NPI number1083487565
StatusActive
Last updated in NPPESNov 6, 2023
Details
- NPI
- 1083487565
- Entity type
- Individual (NPI-1)
- Name
- Viviana Baeza Nunez
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 6, 2023
- Certification date
- Nov 3, 2023
- Last updated
- Nov 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | MAS-4730 | ID | Yes |
Practice location
100 E Idaho StBoise, ID 83712-6267
Phone 208-706-5287
Mailing address
600 N Scotney AveMeridian, ID 83642-7815
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