Individual
LYA RAE DAGGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
1822 21ST STREET, SUITE 101, SACRAMENTO, CA 95816
(916) 501-4012
Mailing address
2510 O ST, APT #1, SACRAMENTO, CA 95816-6300
(916) 501-4012
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21245
CA
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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