Individual
LISA LATREASA STAR SHERIDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
1252 AIRPORT PARK BLD C5, UKIAH, CA 95482
(707) 462-9448
Mailing address
38 W OAK ST, WILLITS, CA 95490
(707) 354-5036
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
90275
CA
Other
Enumeration date
12/19/2022
Last updated
12/19/2022
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