Healthcare Provider Details

I. General information

NPI: 1184538993
Provider Name (Legal Business Name): ALINNA SANDERS-PRINCE LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4168 JUNIATA ST
SAINT LOUIS MO
63116-3931
US

IV. Provider business mailing address

3874 FAIRVIEW AVE
SAINT LOUIS MO
63116-4705
US

V. Phone/Fax

Practice location:
  • Phone: 646-591-5097
  • Fax:
Mailing address:
  • Phone: 646-591-5097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2019018492
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: