Provider Demographics
NPI:1376287409
Name:PLOURDE, DENISE MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
Last Name:PLOURDE
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 1:941 TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-2441
Mailing Address - Country:US
Mailing Address - Phone:860-978-8574
Mailing Address - Fax:
Practice Address - Street 1:941 TEXAS ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-2441
Practice Address - Country:US
Practice Address - Phone:860-978-8574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT008473225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist