Individual
REVENDA JA-MELL MORGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
1350 PLEASANT ST, WINSTON SALEM, NC 27107-1433
(336) 251-4848
Mailing address
1350 PLEASANT ST, WINSTON SALEM, NC 27107-1433
(336) 251-4848
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
08881
NC
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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