Kristen Monique De La Rua, LMT
Massage Therapist in South Miami, FL. Individual provider (NPI-1).
NPI number1982241972
StatusActive
Last updated in NPPESDec 9, 2019
Details
- NPI
- 1982241972
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kristen Monique De La Rua
- Credential
- LMT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 9, 2019
- Certification date
- Dec 9, 2019
- Last updated
- Dec 9, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | MA41588 | FL | Yes |
Practice location
7600 Sw 57th Ave Ste 304South Miami, FL 33143-5427
Phone 305-663-3370
Mailing address
570 Ne 64th St Apt 6Miami, FL 33138-6149
Phone 305-975-1201
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