NPI | 1497105589 |
---|---|
Former Name | TIFFANY LEE DIGUE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA60672868) |
Additional Taxonomies | 247200000X Technician, Other (Licence: WA XT60666196) |
Enumeration Date | 2016-06-20 |
Last Update Date | 2016-07-01 |