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General NPI Number Information
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NPI Number | 1376191775
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Entity Type | Individual
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Provider Name | GINA M VENTURINI LMT
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Gender | Female
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 03/16/2021
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Provider Practice Location Address
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Address Line | 2857 S MERIDIAN RD STE 100
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City | MERIDIAN
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State | ID
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Zip | 83642-7960
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Country | US
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Telephone | 208-888-5858
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Fax | 208-884-1508
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Provider Business Mailing Address
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Address Line | 1775 W STATE ST # 304
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City | BOISE
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State | ID
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Zip | 83702-3924
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Country | US
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Telephone | 303-564-6559
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Fax | 208-884-1508
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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 | MAS-3744
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License Number State |
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