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Individual

MRS. MICHELLE DENISE TALBOT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT, NCTMB

Contact information

Practice address
3002 ARKENDALE ST, WOODBRIDGE, VA 22193-1238
(703) 763-3106
(703) 763-3107
Mailing address
3002 ARKENDALE ST, WOODBRIDGE, VA 22193-1238
(703) 763-3106
(703) 763-3107

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019006655730359
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1629212139
NPI
VA
01
506471-06
NATIONAL CERTIFICATION NUMBER
VA
Enumeration date
04/28/2009
Last updated
01/23/2014
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