Individual
KANIQUE SHANTA MIREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
1230 SE MAYNARD RD STE 203, CARY, NC 27511-6945
(919) 520-5868
Mailing address
1230 SE MAYNARD RD STE 203, CARY, NC 27511-6945
(919) 520-5868
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19142
NC
Other
Enumeration date
01/11/2023
Last updated
01/11/2023
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