Santisouk Prough, CMT
Registered Nurse, Nurse Massage Therapist (NMT) in Peoria, AZ. Individual provider (NPI-1).
NPI number1306691449
StatusActive
Last updated in NPPESFeb 4, 2026
Details
- NPI
- 1306691449
- Entity type
- Individual (NPI-1)
- Name
- Santisouk Prough
- Credential
- CMT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 22, 2024
- Certification date
- Feb 4, 2026
- Last updated
- Feb 4, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WM1400X | Registered Nurse, Nurse Massage Therapist (NMT) | MT | AZ | Yes |
Practice location
8278 W Lake Pleasant PkwyPeoria, AZ 85382-7441
Phone 510-384-5817
Mailing address
19401 N 15th PlPhoenix, AZ 85024-3625
Phone 510-384-5817
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