Individual
LAURA O'NEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
817 SECOND STREET, SANTA ROSA, CA 95404-4609
(707) 536-3394
Mailing address
818 STEWART STREET, SANTA ROSA, CA 95404-3936
(707) 536-3394
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
CAMTC #25012
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25012
CALIFORNIA MASSAGE THERAPY COUNCIL (CAMTC)
CA
Enumeration date
02/02/2015
Last updated
02/02/2015
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