Susan R Stockton, CNMT, LMT
Massage Therapist in Boise, ID. Individual provider (NPI-1).
NPI number1285665232
StatusActive
Last updated in NPPESApr 14, 2024
Details
- NPI
- 1285665232
- Entity type
- Individual (NPI-1)
- Name
- Susan R Stockton
- Credential
- CNMT, LMT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 6, 2006
- Certification date
- Apr 14, 2024
- Last updated
- Apr 14, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | MASG-218 | ID | Yes |
| 225700000X | Massage Therapist | MA44626 | FL | |
| 225700000X | Massage Therapist | MT040994 | TX |
Practice location
575 E Parkcenter Blvd Ste 190Boise, ID 83706-6773
Phone 208-407-7244
Mailing address
13 Red Horse Ridge RdBoise, ID 83716-3125
Phone 208-407-7244
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