Individual
LAKISHA GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
349 ALEXANDER CIR SE, MARIETTA, GA 30060-2238
(404) 669-6426
Mailing address
349 ALEXANDER CIR SE, MARIETTA, GA 30060-2238
(404) 669-6426
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
000997
GA
Other
Enumeration date
09/20/2017
Last updated
07/21/2022
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