Nancy Hagenmayer Lopez - NYS
Licensed Massage Therapist (516) 594-2106Lic.# 005961-1 - In practice since 1991
Deep Tissue Massage - Swedish/European - AMMA - Sports Massage - W. Lowe's Functional
Assessment St. John Neuromuscular Therapy - Mother Massage - CranioSacral Therapy - Myofacial Release The Stretching
Process (Active/Assisted - Passive - PNF)
HIFCA Form
No Fault Information Form
Indicate Form
Client Information Form
Prescription from Doctor must include - Doctor's Name
& ID # Patient Name -Date of Accident Findings -Diagnosis Codes Treatment plan (3 treatments a week
for 8 weeks)
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