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Individual

CHANEL DIANE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2117 CARY GRANT CT, LAS VEGAS, NV 89142-4704
(610) 680-8504
Mailing address
2117 CARY GRANT CT, LAS VEGAS, NV 89142-4704
(610) 680-8504

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
NVMT.13096
NV

Other

Enumeration date
10/25/2025
Last updated
10/25/2025
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