Crystal Donielle Gingras
Massage Therapist in Agana Heights, GU. Individual provider (NPI-1).
NPI number1982256764
StatusActive
Last updated in NPPESJul 12, 2019
Details
- NPI
- 1982256764
- Entity type
- Individual (NPI-1)
- Name
- Crystal Donielle Gingras
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 12, 2019
- Last updated
- Jul 12, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 13-201401340-001 | GU | Yes |
Practice location
382 Tai Gigao RdAgana Heights, GU 96910-6133
Phone 671-788-1980
Mailing address
Po Box 4301Hagatna, GU 96932-8301
Phone 671-788-1980
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