Provider Demographics
NPI:1265026694
Name:TOLENTINO, YESSENIA (LMT)
Entity Type:Individual
Prefix:MS
First Name:YESSENIA
Middle Name:
Last Name:TOLENTINO
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 1:1514 OLD FARM RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1251
Mailing Address - Country:US
Mailing Address - Phone:302-650-4443
Mailing Address - Fax:
Practice Address - Street 1:260 CHAPMAN RD STE 100D
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5410
Practice Address - Country:US
Practice Address - Phone:302-294-1594
Practice Address - Fax:302-294-1594
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEMT-0015101225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty