Individual
TAQUANTA MASHAE PEARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
123 ARISTOCRATIC WAY, LOCUST GROVE, GA 30248-2285
(404) 273-7604
Mailing address
123 ARISTOCRATIC WAY, LOCUST GROVE, GA 30248-2285
(404) 273-7604
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT010416
GA
Other
Enumeration date
07/23/2021
Last updated
07/23/2021
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