| NPI | 1659680700 |
|---|---|
| Former Name | JESSICA ANN SLATER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WV 593400-10) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WV 2010-2725) |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2010-10-06 |