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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LESLIE A DETIENNE

Active Sole Proprietor

LESLIE A DETIENNE is a Massage Therapist healthcare provider located in PORTAGE, Indiana. NPI 1760640759 is currently active in the NPPES registry. Verify at CMS.

Massage Therapist · PORTAGE, IN

Registration Details

NPI Number
1760640759
Provider Type
Individual
Gender
Female
NPI Issued
May 28, 2008 (18.256899925277 yrs)
Last Updated
May 28, 2008
Sole Proprietor
Yes

Practice Information

Address
5934 US HIGHWAY 6
PORTAGE, IN, 463684946
Browse IN providers · Browse ZIP 46368
Phone
2197627136
Primary Specialty
Massage Therapist
225700000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.