Moon Leaf Derosier, CMT

NPI #1043663438 in Atascadero, California

Provider Information

NPI Number: 1043663438
Entity Type: Individual
Name: Moon Leaf Derosier, CMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: CMT
Enumeration Date: Jul 20, 2016
Last Updated: Jul 20, 2016

Practice Location

Address: 5960B WEST MALL
City: Atascadero
State: California
ZIP Code: 93422-4232
Phone: (415) 706-6397

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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