Individual
ROBERTA JEAN BOISSELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
980 SEVEN LAKES DRIVE, SUITE 3, SEVEN LAKES, NC 27376
(910) 673-2000
Mailing address
PO BOX 951, WEST END, NC 27376-0951
(910) 673-2000
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
01573
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01573
NORTH CAROLINA BOARD OF MASSAGE THERAPY AND BODYWORK LICENSE
NC
Enumeration date
12/16/2022
Last updated
12/16/2022
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