Provider Demographics
NPI:1851503775
Name:STANIER, TAMARA BETH (LMT)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:BETH
Last Name:STANIER
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 1:10442 BANTLE ROAD
Mailing Address - Street 2:
Mailing Address - City:NORTH COLLINS
Mailing Address - State:NY
Mailing Address - Zip Code:14111
Mailing Address - Country:US
Mailing Address - Phone:716-480-2454
Mailing Address - Fax:
Practice Address - Street 1:90 HAMBURG STREET
Practice Address - Street 2:MASSAGE WORKS
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052
Practice Address - Country:US
Practice Address - Phone:716-655-2533
Practice Address - Fax:716-655-2533
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013552225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist