Individual
JENNIFER ELIZABETH WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4416 TRENTON ST, METAIRIE, LA 70006-6527
(504) 250-3962
Mailing address
806 JOE YENNI BLVD APT 18, KENNER, LA 70065
(504) 250-3962
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LA2119
LA
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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