Individual
MS. JESSICA RAE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
3029 MARY CREST DR, SHELBYVILLE, KY 40065-6354
(502) 417-4492
Mailing address
3029 MARY CREST DR, SHELBYVILLE, KY 40065-6354
(502) 417-4492
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1285
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KY-1285
KENTUCKY STATE MASSAGE THERAPY LICENSE ID
KY
Enumeration date
04/28/2010
Last updated
07/01/2010
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