NPI 1295431773

Wanda Lee Wade, LMTCMLDT

Practitioner Massage Therapist Northport, NY

Practice location

Address: 5 Vause St, Northport, NY 11768-2118
Phone: (631) 327-3324

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 027200-01 (NY)

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Registry record

NPI: 1295431773
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Feb 2023
Record last updated: 6 Feb 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.