Individual
FELICIA SQUIRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3941 SAINT IVES RD UNIT 911, MYRTLE BEACH, SC 29588-1174
(518) 788-6866
Mailing address
3941 SAINT IVES RD UNIT 911, MYRTLE BEACH, SC 29588-1174
(518) 788-6866
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7097
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7097
MASSAGE THERAPY LICENSE
SC
Enumeration date
02/26/2013
Last updated
02/26/2013
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