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General NPI Number Information
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NPI Number | 1871300889
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Entity Type | Individual
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Provider Name | MARCI JAVRIL NCTMB, CST, CMT
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Gender | Female
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 4316 ALLA RD APT 9
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City | LOS ANGELES
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State | CA
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Zip | 90066-6160
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Country | US
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Telephone | 310-486-4753
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Fax |
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Provider Business Mailing Address
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Address Line | 13157 MINDANAO WAY # 1440
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City | MARINA DEL REY
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State | CA
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Zip | 90292-6307
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Country | US
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Telephone | 310-486-4753
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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 | 30816
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License Number State | CA
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