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Individual
WANDA ELIZABETH NORMAN
Active
Individual
WANDA ELIZABETH NORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT, LAC
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC150417
OR
225700000X
Massage Therapist
12447
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12447
MASSAGE LICENSE
OR
01
—
AC150417
ACUPUNCTURE LICENSE
OR
Enumeration date
01/31/2010
Last updated
02/20/2015
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