| Stasha Provitt, | |
|
277 Pleasant St Unit 109, Pasadena, CA 91101-3198 | |
| (213) 434-8672 | |
| Not Available |
| Full Name | Stasha Provitt |
|---|---|
| Gender | Female |
| Speciality | Massage Therapist |
| Location | 277 Pleasant St Unit 109, Pasadena, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629647151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | (NU) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Stasha Provitt, 277 Pleasant St Unit 109, Pasadena, CA 91101-3198 Ph: (213) 434-8672 | Stasha Provitt, 277 Pleasant St Unit 109, Pasadena, CA 91101-3198 Ph: (213) 434-8672 |
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