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General NPI Number Information
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NPI Number | 1881349710
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Entity Type | Individual
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Provider Name | MARCIA MARIA DE CAMPOS
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Gender | Female
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Dates
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Enumeration Date | 02/18/2022
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Last Update Date | 02/18/2022
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Provider Practice Location Address
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Address Line | 240 BEDFORD ST STE 5
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City | LEXINGTON
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State | MA
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Zip | 02420-3400
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Country | US
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Telephone | 978-893-8532
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Fax |
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Provider Business Mailing Address
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Address Line | 208 SWANSON RD UNIT 536
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City | BOXBOROUGH
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State | MA
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Zip | 01719-1333
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Country | US
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Telephone | 978-893-8532
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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 | 12786
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License Number State | MA
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