NPI | 1881907566 |
---|---|
Former Name | CRYSTAL YVETTE OLSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225700000X Massage Therapist (Licence: WA ma 60084404) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ MT-09920) |
Enumeration Date | 2010-07-22 |
Last Update Date | 2010-09-29 |