Provider Demographics
NPI:1407056971
Name:MASON, EMMA JANE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:JANE
Last Name:MASON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
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Mailing Address - Street 1:1466 HYDE PARK DR
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-8142
Mailing Address - Country:US
Mailing Address - Phone:407-657-5029
Mailing Address - Fax:407-657-6320
Practice Address - Street 1:1890 STATE ROAD 436
Practice Address - Street 2:SUITE 251
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2228
Practice Address - Country:US
Practice Address - Phone:407-657-5029
Practice Address - Fax:407-657-6320
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLMA42422225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist