Individual
JOANNA PATRICIA ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2596 N STOKESBERRY PL STE 130, MERIDIAN, ID 83646-6087
(208) 713-6425
Mailing address
953 E BLUE HERON ST, MERIDIAN, ID 83646-3463
(208) 713-6425
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3207
ID
Other
Enumeration date
09/24/2020
Last updated
04/25/2022
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