Individual
MICHELLE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT#8540,CNMT
Contact information
Practice address
6303 INDIAN SCHOOL RD NE, SUITE 102B, ALBUQUERQUE, NM 87110-5328
(505) 582-1176
Mailing address
4610 EUBANK BLVD NE, APT 103, ALBUQUERQUE, NM 87111-2553
(505) 206-7180
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8540
NM
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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