Individual
MS. DONNA MARIE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1342 TIMBERLANE RD, SUITE 102-B, TALLAHASSEE, FL 32312-1762
(850) 893-6868
(950) 894-7023
Mailing address
1342 TIMBERLANE RD, SUITE 102-B, TALLAHASSEE, FL 32312-1762
(850) 893-6868
(950) 894-7023
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA12316
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C5358
BLUE CROSS BLUE SHIELD
FL
01
—
MA12316
MASSAGE LICENSE NUMBER
FL
Enumeration date
05/29/2007
Last updated
07/08/2007
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