Individual
MISS TRACI LYNN DERR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HHP, CMT
Contact information
Practice address
8528 N MAGNOLIA AVE STE 102, SANTEE, CA 92071-4692
(619) 972-8650
Mailing address
8528 N MAGNOLIA AVE STE 102, SANTEE, CA 92071-4692
(619) 972-8650
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
61672
CA
Other
Enumeration date
12/05/2015
Last updated
09/21/2021
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