Individual
TAWANA THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
180 BROADWAY APT 3, BAYONNE, NJ 07002-2436
(347) 977-2776
Mailing address
180 BROADWAY APT 3, BAYONNE, NJ 07002-2436
(347) 977-2776
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
026723-01
NY
225700000X
Massage Therapist
Primary
18KT01452600
NJ
Other
Enumeration date
12/26/2022
Last updated
12/26/2022
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