Individual
BRENDA WAKEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
665 W LBJ FWY, IRVING, TX 75063-3712
(214) 380-9700
Mailing address
10225 MARCHANT LN, IRVING, TX 75063-4503
(937) 620-4286
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT110561
TX
Other
Enumeration date
10/22/2009
Last updated
04/02/2013
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