Individual
MRS. KARISSA JOY CRESWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5241
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5241
NM MASSAGE THERAPY BOARD
NM
Enumeration date
05/29/2015
Last updated
05/29/2015
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