Individual
MISS SHATINSLEY NICOLE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7214 HIGHWAY 78 STE 10, SACHSE, TX 75048-2532
(214) 785-8832
Mailing address
PO BOX 1919, FORNEY, TX 75126-1919
(469) 332-8650
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT127033
TX
Other
Enumeration date
09/11/2018
Last updated
11/19/2021
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