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Individual

MRS. JENNIFER CECILIA SOUTHWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
1720 S EDMONDS LN STE 107, LEWISVILLE, TX 75067-5805
(214) 497-5382
Mailing address
995 DOWNEY DR, LEWISVILLE, TX 75067-7436
(214) 497-5382

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT048441
TX

Other

Enumeration date
11/27/2021
Last updated
11/27/2021
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