Provider Demographics
NPI:1386482859
Name:LEYVA, DULSE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:DULSE
Middle Name:
Last Name:LEYVA
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:DULSE
Other - Middle Name:M
Other - Last Name:LEYVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MASSAGE THERAPIST
Mailing Address - Street 1:5335 E SHEA BLVD APT 2066
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5735
Mailing Address - Country:US
Mailing Address - Phone:623-385-9427
Mailing Address - Fax:
Practice Address - Street 1:5335 E SHEA BLVD APT 2066
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5735
Practice Address - Country:US
Practice Address - Phone:623-385-9427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-21834225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist