Individual
STEPHANIE MICHELLE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
629 A PASEO DEL PUEBLO SUR, TAOS, NM 87571
(509) 668-8393
Mailing address
PO BOX 107, TRES PIEDRAS, NM 87577
(509) 668-8393
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7639
NM
Other
Enumeration date
07/09/2013
Last updated
07/09/2013
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