Individual
JACLYN LAGRAVINESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
16025 S 50TH ST APT 1017, PHOENIX, AZ 85048-5002
(480) 510-5352
Mailing address
16025 S 50TH ST APT 1017, PHOENIX, AZ 85048-5002
(480) 510-5352
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17459
AZ
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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