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General NPI Number Information
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NPI Number | 1497402630
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Entity Type | Individual
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Provider Name | ELIZABETH COURDUFF LMT
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Gender | Female
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Dates
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Enumeration Date | 03/08/2022
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Last Update Date | 03/08/2022
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Provider Practice Location Address
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Address Line | 2401 PENNSYLVANIA AVE STE 102
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City | WILMINGTON
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State | DE
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Zip | 19806-1432
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Country | US
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Telephone | 302-357-0951
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Fax |
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Provider Business Mailing Address
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Address Line | 246 EMMA WAY
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City | NEWARK
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State | DE
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Zip | 19702-4808
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Country | US
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Telephone | 302-256-1843
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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 | MT-0003001
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License Number State | DE
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