Individual
KAYLA MARISSA STASIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
1300 ADAMS AVE APT 26M, COSTA MESA, CA 92626-8329
(657) 248-1664
Mailing address
1300 ADAMS AVE APT 26M, COSTA MESA, CA 92626-8329
(657) 248-1664
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
76737
CA
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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