Diane Shenk, LMT

Individual provider Active NPI Massage Therapist · Santa Fe, NM

NPI 1154586642 · NPPES record last updated Jul 23, 2008

Key facts

NPI
1154586642
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
1356 (NM)
Practice address
2801 Rodeo Rd Ste C14
Santa Fe, NM 87507-6503
Phone
(505) 474-4222
NPI assigned
Jul 23, 2008
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1356NMMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Massage & Banya Spa of Santa Fe Massage Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 1356 NM Yes

Addresses

Primary practice location

2801 Rodeo Rd Ste C14
Santa Fe, NM 87507-6503

Mailing address

1721B Camino Dos Antonios
Santa Fe, NM 87507-3263

Other providers in Santa Fe, NM

All providers in Santa Fe, NM · Massage Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.