Provider Demographics
NPI:1669748448
Name:CECHMANKOVA, DANIELA (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MISS
First Name:DANIELA
Middle Name:
Last Name:CECHMANKOVA
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:766 WALKER RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-2652
Mailing Address - Country:US
Mailing Address - Phone:703-638-4852
Mailing Address - Fax:
Practice Address - Street 1:766 WALKER RD
Practice Address - Street 2:SUITE E
Practice Address - City:GREAT FALLS
Practice Address - State:VA
Practice Address - Zip Code:22066-2652
Practice Address - Country:US
Practice Address - Phone:703-638-4852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA583585-09225700000X
VA0019008838225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0019008838OtherBOARD OF NURSING(COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH PROFESSIONALS)
VA583585-09OtherNCTMB