Individual
SHANNON MICHELLE INNIS-GIELISSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMP, AIMI, CYI
Contact information
Practice address
6108 JASON CT, APTOS, CA 95003-6012
(831) 419-7552
Mailing address
6108 JASON CT, APTOS, CA 95003-6012
(831) 419-7552
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24270
CA
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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