Individual
JESSICA LAINE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6505 AVA COURT DR, FORT WORTH, TX 76112-8008
(682) 433-9615
Mailing address
6505 AVA COURT DR, FORT WORTH, TX 76112-8008
(682) 433-9615
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
—
—
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
03/02/2023
Last updated
03/02/2023
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