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Individual

MRS. MEGAN KENZIE OLLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NC LMBT

Contact information

Practice address
203B LONG ST, JEFFERSON, NC 28640-9518
(336) 620-7125
Mailing address
2007A BEN BOLEN RD, CRESTON, NC 28615-9518
(336) 620-7125

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15736
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0
NOT AVAILABLE
Enumeration date
01/04/2023
Last updated
01/04/2023
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