Individual
AMANDA TIBBETTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT,NMT, PMT
Contact information
Practice address
10755 KLING ST APT 110, NORTH HOLLYWOOD, CA 91602-1493
(323) 350-8284
Mailing address
10755 KLING ST APT 110, NORTH HOLLYWOOD, CA 91602-1493
(323) 350-8284
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
77401
CA
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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