Provider Demographics
NPI:1245378777
Name:HOLSINGER, PAULA RELYEA (LMT)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:RELYEA
Last Name:HOLSINGER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-4214
Mailing Address - Country:US
Mailing Address - Phone:321-773-5787
Mailing Address - Fax:
Practice Address - Street 1:320 4TH AVE
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-4214
Practice Address - Country:US
Practice Address - Phone:321-773-5787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22814225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22814OtherMASSAGE THERAPIST