Provider Demographics
NPI:1740814946
Name:SAHADI VEGA, MELANIE J (LMT)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:J
Last Name:SAHADI VEGA
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 1:929 SALEM ST # 9
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:MA
Mailing Address - Zip Code:01834-1515
Mailing Address - Country:US
Mailing Address - Phone:978-352-7677
Mailing Address - Fax:
Practice Address - Street 1:929 SALEM ST # 9
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:MA
Practice Address - Zip Code:01834-1515
Practice Address - Country:US
Practice Address - Phone:978-352-7677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13346225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist