JENNIFER LEE VAN WYNGAARDT LMT
NPI 1093562936
Massage Therapist in Saint Augustine, FL
Active since April 30, 2024
About Jennifer Lee Van Wyngaardt Lmt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JENNIFER LEE VAN WYNGAARDT LMT (NPI 1093562936) is an individual massage therapist in Saint Augustine, Florida, licensed in Florida (97382) and active in the NPI registry since April 2024.
NPPES Registry Identity
NPI1093562936
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameJENNIFER LEE VAN WYNGAARDTCredential: LMT
Location Address1797 OLD MOULTRIE RD STE 103Saint Augustine, FL 32084-5721
Mailing Address255 Whispering Woods Ln Apt 6Saint Augustine, FL 32084-5910 · (904) 844-1616
Phone(904) 844-1616
Sole ProprietorNo
Enumeration DateApril 30, 2024
NPPES CertifiedApril 30, 2024
✔ NPI 1093562936 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in FL · 97382
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
1797 OLD MOULTRIE RD STE 103, Saint Augustine, FL 32084
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1093562936, enumerated as an "individual" on April 30, 2024.
The provider is located at 1797 OLD MOULTRIE RD STE 103 SAINT AUGUSTINE, FL 32084 and the phone number is (904) 844-1616.
Massage Therapist with taxonomy code 225700000X.
