Lisa Marie Ivens, LMT

Individual provider Active NPI Massage Therapist · Foster, RI

NPI 1295033603 · NPPES record last updated Mar 9, 2011

Key facts

NPI
1295033603
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MT00552 (RI)
Practice address
142A Danielson Pike
Foster, RI 02825-1475
Phone
(401) 241-1924
NPI assigned
Mar 9, 2011
Sex
Female
Sole proprietor
Yes

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
MT00552RIMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT00552 RI Yes

Addresses

Primary practice location

142A Danielson Pike
Foster, RI 02825-1475

Mailing address

142A Danielson Pike
Foster, RI 02825-1475
Phone (401) 241-1924

Other providers in Foster, RI

All providers in Foster, RI · Massage Therapist in Rhode Island

Sources for this page

Verify at the official NPI Registry.