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General NPI Number Information
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NPI Number | 1437453198
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Entity Type | Individual
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Provider Name | ROBIN LYNN MORALLI L.M.T
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Gender | Female
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 04/13/2012
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Provider Practice Location Address
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Address Line | 616 HEMLOCK ST SUITE B
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City | BROOKINGS
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State | OR
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Zip | 97415-9456
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Country | US
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Telephone | 541-813-1863
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Fax |
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Provider Business Mailing Address
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Address Line | 422 PINE ST
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City | BROOKINGS
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State | OR
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Zip | 97415-9045
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Country | US
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Telephone | 503-764-6190
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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 | 17782
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License Number State | OR
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