Provider Demographics
NPI:1245736016
Name:DA ROCHA PEREIRA, ANA FLAVIA (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:FLAVIA
Last Name:DA ROCHA PEREIRA
Suffix:
Gender:F
Credentials:LMT
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Mailing Address - Street 1:11200 STILLWATER BLVD N
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LAKE ELMO
Mailing Address - State:MN
Mailing Address - Zip Code:55042-9603
Mailing Address - Country:US
Mailing Address - Phone:612-386-9242
Mailing Address - Fax:
Practice Address - Street 1:11200 STILLWATER BLVD N
Practice Address - Street 2:SUITE 102
Practice Address - City:LAKE ELMO
Practice Address - State:MN
Practice Address - Zip Code:55042-9603
Practice Address - Country:US
Practice Address - Phone:612-386-9242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist