Individual
STACY LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MLD, CMT
Contact information
Practice address
9535 OTIS ST, SOUTH GATE, CA 90280-4927
(323) 430-7748
Mailing address
9628 DOROTHY AVE, SOUTH GATE, CA 90280-5110
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
91604
CA
Other
Enumeration date
11/02/2023
Last updated
11/02/2023
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