Individual provider · Type 1 NPI

Maxine Souvenir, LMT

Massage Therapist · Elizabeth, NJ

NPI number 1790401966 Active

Practice location

100 Union St Apt 518
Elizabeth, NJ 07202-2171

Call (347) 422-4370 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X18KT01438900 (NJ)

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 1790401966

Maxine Souvenir, LMT's National Provider Identifier is 1790401966, issued on Oct 18, 2022. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Elizabeth, NJ. The record was last updated on Oct 18, 2022.