Individual
TALISHA DORAY MINOR- JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10500 WAKEMAN DR STE 500, FREDERICKSBURG, VA 22407-8014
(540) 785-7888
Mailing address
10500 WAKEMAN DR STE 500, FREDERICKSBURG, VA 22407-8014
(540) 785-7888
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019008826
VA
Other
Enumeration date
10/22/2025
Last updated
10/22/2025
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