Provider Demographics
NPI:1639358534
Name:FRIEDLAND, MOIRA MARIA (NCTMB LMT MASSAGE TH)
Entity Type:Individual
Prefix:MRS
First Name:MOIRA
Middle Name:MARIA
Last Name:FRIEDLAND
Suffix:
Gender:F
Credentials:NCTMB LMT MASSAGE TH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 HILLTOP DR APT 21
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-4836
Mailing Address - Country:US
Mailing Address - Phone:928-225-9062
Mailing Address - Fax:
Practice Address - Street 1:591 HILLTOP DR APT 21
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-4836
Practice Address - Country:US
Practice Address - Phone:928-225-9062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2017-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69546390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program