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General NPI Number Information
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NPI Number | 1649096108
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Entity Type | Individual
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Provider Name | ANAYSHA K GREENIDGE LMT
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 1088 E ALTAMONTE DR STE 105
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-5013
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Country | US
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Telephone | 407-506-5215
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Fax |
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Provider Business Mailing Address
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Address Line | 556 LITTLE RIVER LOOP APT 131
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-1781
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Country | US
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Telephone | 321-334-8933
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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 | MA91483
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License Number State |
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