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NPI 1366794752

NPI 1366794752 : DONNA HOWARD SAINTVIL LMBT : CHARLOTTE, NC

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General NPI Number Information
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    NPI Number           |    1366794752
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    Entity Type          |    Individual 
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    Provider Name        |    DONNA HOWARD SAINTVIL LMBT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/09/2012
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    Last Update Date     |    10/09/2012
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Provider Practice Location Address
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    Address Line         |    16147 LANCASTER HWY 110
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    City                 |    CHARLOTTE
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    State                |    NC
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    Zip                  |    28277-2050
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    Country              |    US
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    Telephone            |    252-468-2147
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    236 BRIDFORD DOWNS DR 
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    City                 |    GREENSBORO
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    State                |    NC
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    Zip                  |    27407-2767
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    Country              |    US
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    Telephone            |    252-468-2147
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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       |    12061
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    License Number State |    NC
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