Kim Su Ann Dermody, LMT

NPI #1154572352 in Wading River, New York

Provider Information

NPI Number: 1154572352
Entity Type: Individual
Name: Kim Su Ann Dermody, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Oct 7, 2008
Last Updated: Oct 7, 2008

Practice Location

Address: 2 SOUND RD
Address 2: D
City: Wading River
State: New York
ZIP Code: 11792-1033
Phone: (631) 886-1999

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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