Provider Demographics
NPI:1366173122
Name:PREVAL, WENSHY (LMT)
Entity type:Individual
Prefix:MS
First Name:WENSHY
Middle Name:
Last Name:PREVAL
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 1:127 GREYROCK PL APT 704
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-3107
Mailing Address - Country:US
Mailing Address - Phone:203-252-9859
Mailing Address - Fax:
Practice Address - Street 1:127 GREYROCK PL APT 704
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-3107
Practice Address - Country:US
Practice Address - Phone:203-252-9859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10341225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT10341OtherCT MASSAGE THERAPIST