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Individual

MRS. MICHELLE MAE LEVELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
221 W ROOSEVELT AVE, ELECTRA, TX 76360-2437
(940) 632-0558
Mailing address
105 AVENUE A, ELECTRA, TX 76360-1447
(940) 632-0558

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT038536
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MT038536
MASSAGE THERAPIST LICENSE NUMBER
TX
Enumeration date
05/20/2009
Last updated
05/20/2009
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