Individual
LISA ROSE MASSICOTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2836 LAVISTA RD STE D, DECATUR, GA 30033-1301
(404) 438-6154
Mailing address
625 PIEDMONT AVE NE UNIT 1017, ATLANTA, GA 30308-6204
(860) 459-1919
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT015344
GA
Other
Enumeration date
01/19/2026
Last updated
01/19/2026
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