Individual
KELISHA MONIQUE DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2715 W LA SALLE ST, PHOENIX, AZ 85041-3458
(510) 696-0000
Mailing address
2715 W LA SALLE ST, PHOENIX, AZ 85041-3458
(100) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-29860
AZ
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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