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General NPI Number Information
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NPI Number | 1891073995
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Entity Type | Individual
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Provider Name | KAREN M FAYNE LMT
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Gender | Female
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Dates
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Enumeration Date | 07/25/2011
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Last Update Date | 07/25/2011
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Provider Practice Location Address
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Address Line | 36 WOBURN ST
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City | READING
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State | MA
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Zip | 01867
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Country | US
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Telephone | 781-864-3949
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 244
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City | SAGAMORE BEACH
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State | MA
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Zip | 02562
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Country | US
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Telephone | 781-864-3949
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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 | 2456
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | S04596698
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License Number State | MA
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