Individual
IMELDA LUCIA JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2077 N ZARAGOZA RD # A102, EL PASO, TX 79938-7900
(915) 274-4125
Mailing address
9030 BETEL DR APT D11, EL PASO, TX 79907-2950
(915) 208-1009
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT118238
TX
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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