Tara Surprenant, LMT
Massage Therapist in Hayden, ID. Individual provider (NPI-1).
NPI number1710698212
StatusActive
Last updated in NPPESDec 6, 2022
Details
- NPI
- 1710698212
- Entity type
- Individual (NPI-1)
- Name
- Tara Surprenant
- Credential
- LMT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 6, 2022
- Certification date
- Dec 6, 2022
- Last updated
- Dec 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | MAS4938 | ID | Yes |
Practice location
2151 W Hayden AveHayden, ID 83835-7414
Phone 208-762-6772
Mailing address
2151 W Hayden AveHayden, ID 83835-7414
Phone 208-762-6772
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All 67 Massage Therapist providers in Hayden · All 521 providers in Hayden
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