Individual
JACQUELINE DEFIESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
5578 LONGLEY LN, RENO, NV 89511-1825
(775) 284-8650
(775) 284-8654
Mailing address
1464 GRANARY PARK AVE, SPARKS, NV 89436-3754
(775) 722-1903
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9649
NV
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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