Darlene M Longstreth

Individual provider Active NPI Massage Therapist · Brookhaven, PA

NPI 1790959633 · NPPES record last updated Apr 22, 2008

Key facts

NPI
1790959633
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
PSMT (PA)
Practice address
3766 Susan Lane
Kinderssage
Brookhaven, PA 19015
Phone
(610) 505-8946
NPI assigned
Apr 22, 2008
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
PSMTPAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X PSMT PA Yes

Addresses

Primary practice location

3766 Susan Lane
Kinderssage
Brookhaven, PA 19015

Mailing address

8241 Pine Rd
Philadelphia, PA 19111-1823
Phone (267) 972-0448

Other providers in Brookhaven, PA

All providers in Brookhaven, PA · Massage Therapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.