Individual
MS. LARA BISHOP TEILE
Active
Individual
MS. LARA BISHOP TEILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RMT, CNMT, MLD
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
MT-0015642
CO
225700000X
Massage Therapist
Primary
MT0015642
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT0015642
DORA
CO
Enumeration date
12/02/2013
Last updated
04/18/2014
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