Provider Demographics
NPI:1194924696
Name:LENHAUSEN, AUDREY MAY (NMT, LBMT)
Entity type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:MAY
Last Name:LENHAUSEN
Suffix:
Gender:F
Credentials:NMT, LBMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10712 CHELTONHAM CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-9015
Mailing Address - Country:US
Mailing Address - Phone:678-516-2396
Mailing Address - Fax:
Practice Address - Street 1:216 E CHATHAM ST
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3495
Practice Address - Country:US
Practice Address - Phone:919-466-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC05277225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist