Individual provider · Type 1 NPI
Haveliah Stark, LMT
Massage Therapist · Charleston, IL
NPI number
1104377944
Active
Practice location
2115 18th St
Charleston, IL 61920-4338
Mailing address
1606 11th St
Charleston, IL 61920-3509
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | 227.012934 (IL) |
| Massage Therapist | 225700000X | 7501003525 (MI) |
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.
2 other providers at this address
Other massage therapist providers in Charleston
About NPI 1104377944
Haveliah Stark, LMT's National Provider Identifier is 1104377944, issued on Oct 17, 2016. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Charleston, IL. The record was last updated on Oct 17, 2016.