Individual
STEPHANIE RACHELE BACQUET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22077 MOCKINGBIRD LANE, CEDARPINES PARK, CA 92322
(909) 338-7185
Mailing address
PO BOX 5176, CRESTLINE, CA 92325-5176
(909) 338-7185
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18978
CA
Other
Enumeration date
02/04/2011
Last updated
03/10/2011
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