Provider Demographics
NPI:1245307974
Name:MUINA, NATALIA (LIC AC)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:MUINA
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 DEDHAM ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2902
Mailing Address - Country:US
Mailing Address - Phone:617-630-5606
Mailing Address - Fax:
Practice Address - Street 1:349 DEDHAM ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-2902
Practice Address - Country:US
Practice Address - Phone:617-630-5606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA108171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist