Individual
MRS. ROBIN VANESSA BLAISDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
214 W CENTER ST, HERNANDO, MS 38632-2242
(662) 782-6770
Mailing address
6695 WHITE HAWK LN, OLIVE BRANCH, MS 38654-7382
(662) 782-6770
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
969
MS
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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