Individual
MISS DA'KEA JAUNTE BOUTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CLINICAL MASSAGE
Contact information
Practice address
7306 LEITNER RD, COLUMBIA, SC 29209-2923
(843) 323-1631
Mailing address
7306 LEITNER RD, COLUMBIA, SC 29209-2923
(843) 323-1631
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12455
SC
Other
Enumeration date
01/07/2022
Last updated
01/07/2022
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