Individual
MS. LARISSA KIDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
517 N 14TH ST STE 2, PARAGOULD, AR 72450-3550
(870) 335-7576
Mailing address
92 GREENE 712 RD, PARAGOULD, AR 72450-8269
(870) 335-7576
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4884
AR
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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