MEDICARE: DEBORAH GUZMAN LMBT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	19178	NC

General Provider Information

NPI Number	:	1679153647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH GUZMAN LMBT

Provider Business Mailing Address
First Line	:	PO BOX 4564
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27404-4564
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2105 W CORNWALLIS DR STE C
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27408-7098
Country	:	US
Telephone Number	:	336-907-7741
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2021
Last Update Date	:	04/13/2021

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