NPI | 1093030041 |
---|---|
Former Name | JESSICA RENEE MALABANAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MP60939879) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 16232) |
Enumeration Date | 2010-04-01 |
Last Update Date | 2019-04-24 |