Doctor Name: | MRS. IVONE CORVALAN OSBORNE |
NPI Number: | 1912155425 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CMT |
License Number: | 0019005149 |
Business Practice Address: | 8550 Arlington Blvd Ste 325 Fairfax, VA - 220314647 |
Business Phone Number: | 7036987117 |
Business Fax Number: | 7036985729 |
Mailing Address: | 11441 Fogarty Ct, FAIRFAX |
State: | VA |
Postal Code: | 220308555 |
Phone Number: | 2404768224 |
Fax Number: | 7032727579 |
NPI Enumeration Date: | 09/09/2008 |
NPI Last Update Date: | 09/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 0019005149 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |