Healthcare Provider Details

I. General information

NPI: 1205228103
Provider Name (Legal Business Name): ELIZABETH M SAENZ LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2015
Last Update Date: 03/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 SAINT JOHN ST FIRST FLOOR
HAVRE DE GRACE MD
21078-2817
US

IV. Provider business mailing address

330 SAINT JOHN ST FIRST FLOOR
HAVRE DE GRACE MD
21078-2817
US

V. Phone/Fax

Practice location:
  • Phone: 443-866-6534
  • Fax:
Mailing address:
  • Phone: 443-866-6534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberM04645
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: