Individual
MS. MARISSA TAIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
11706 KLING ST, APT 8, VALLEY VILLAGE, CA 91607-4045
(323) 972-1727
Mailing address
11706 KLING ST, APT 8, VALLEY VILLAGE, CA 91607-4045
(323) 972-1727
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
48655
CA
Other
Enumeration date
11/19/2016
Last updated
11/19/2016
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