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General NPI Number Information
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NPI Number | 1164386082
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Entity Type | Individual
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Provider Name | ASHLEY JUSTINIANO CMT
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Gender | Female
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 312 CEDAR LAKES DR STE 101
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City | CHESAPEAKE
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State | VA
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Zip | 23322-8380
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Country | US
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Telephone | 757-546-0031
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Fax | 757-482-9379
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Provider Business Mailing Address
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Address Line | 4621 WINDERMERE AVE
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City | NORFOLK
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State | VA
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Zip | 23513-5428
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Country | US
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Telephone | 757-581-2600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 0019014944
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License Number State | VA
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