Individual
LAURA MICHELLE PRIVETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
117 W SABINE ST, CARTHAGE, TX 75633-2609
(903) 263-8017
Mailing address
3455 FM 699, CARTHAGE, TX 75633-4713
(903) 263-8017
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT126017
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT126017
TDLR MASSAGE THERAPY
TX
Enumeration date
07/23/2020
Last updated
07/23/2020
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