Individual
MRS. ELISE NICOLE VAN TASSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
UT
225700000X
Massage Therapist
Primary
14239616-4701
UT
Other
Enumeration date
09/20/2024
Last updated
08/29/2025
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