Individual
CASSANDRA TANTIBANCHACHAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9601 CUSTER RD, PLANO, TX 75025-7527
(469) 614-9527
Mailing address
9611 CUSTER RD APT 1816, PLANO, TX 75025-6521
(469) 614-9527
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT124696
TX
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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