Individual provider · Type 1 NPI

Jacqueline Marie Sullivan, LMT

Massage Therapist · Ogdensburg, NY

NPI number 1023255395 Active

Practice location

609 Canton St
Ogdensburg, NY 13669-3811

Call (315) 393-1018 Map

Fax (315) 393-1075

Mailing address

609 Canton Street
Ogdensburg, NY 13669-0000

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X021153 (NY)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1023255395

Jacqueline Marie Sullivan, LMT's National Provider Identifier is 1023255395, issued on Jan 8, 2009. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Ogdensburg, NY. The record was last updated on Jan 8, 2009.