Individual
MS. DESTINE NICOLE HALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
170 CUNAT BLVD APT 3D, RICHMOND, IL 60071-8964
(228) 343-9641
Mailing address
170 CUNAT BLVD APT 3D, RICHMOND, IL 60071-8964
(228) 343-9641
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.021923
IL
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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