Individual
AIYANA LACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
5509 PLEASANT VALLEY DR STE 70, PLANO, TX 75023-5225
(214) 470-7603
Mailing address
1001 ROSS AVE APT 466, DALLAS, TX 75202-2232
(214) 470-7603
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT005902
GA
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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