Individual
MISS KRISTY MARIE WILLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
311 ALFRED ST, BIDDEFORD, ME 04005-3127
(207) 286-8416
Mailing address
374 SOUTH ST APT 5, BIDDEFORD, ME 04005-9397
(207) 219-0462
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT6859
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT6859
LMT
ME
Enumeration date
08/24/2021
Last updated
08/24/2021
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