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NPI 1811869126

NPI 1811869126 : SHANNON LOUISE LUONGO LMT : LEOMINSTER, MA

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General NPI Number Information
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    NPI Number           |    1811869126
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    Entity Type          |    Individual 
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    Provider Name        |    SHANNON LOUISE LUONGO LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/18/2025
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    Last Update Date     |    09/18/2025
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Provider Practice Location Address
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    Address Line         |    1137 MAIN ST 
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    City                 |    LEOMINSTER
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    State                |    MA
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    Zip                  |    01453-1753
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    Country              |    US
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    Telephone            |    978-534-0101
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    20 BLOOD RD 
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    City                 |    TOWNSEND
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    State                |    MA
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    Zip                  |    01469-1255
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    Country              |    US
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    Telephone            |    978-496-4431
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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       |    4021
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    License Number State |    MA
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