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Individual

ERIN BERNICE LEGROS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MASSAGE THERAPIST

Contact information

Practice address
740 E 52ND ST, SUITE 12, INDIANAPOLIS, IN 46205-1172
(317) 921-0972
Mailing address
622 W 39TH ST, INDIANAPOLIS, IN 46208-3929
(317) 921-0972

Taxonomy

Speciality
Code
Description
License number
State
173C00000X
Reflexologist
MT20903164
IN
174H00000X
Health Educator
MT20903164
IN
225700000X
Massage Therapist
Primary
MT20903164
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MT20903164
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
06/14/2010
Last updated
06/14/2010
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