Individual
STEPHANIE JANE BRACKEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
95 BASSINGHAM DR, BELLA VISTA, AR 72715-1526
(760) 421-2303
Mailing address
95 BASSINGHAM DR, BELLA VISTA, AR 72715-1526
(760) 421-2303
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
031998
NY
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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