Provider Demographics
NPI:1245522044
Name:HOWARD, WANDA SUE (LMT)
Entity type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:SUE
Last Name:HOWARD
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 1:1864 OREGON PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6402
Mailing Address - Country:US
Mailing Address - Phone:717-519-6700
Mailing Address - Fax:
Practice Address - Street 1:1864 OREGON PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6402
Practice Address - Country:US
Practice Address - Phone:717-519-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG000524225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMSG000524OtherMASSAGE THERAPY STATE LICENSE NUMBER