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Individual

EMILY DUDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
158 S HOUSTON LAKE RD, STE 2, WARNER ROBINS, GA 31088-8017
(478) 202-7260
Mailing address
158 S HOUSTON LAKE RD, STE 2, WARNER ROBINS, GA 31088-8017
(478) 202-7260

Taxonomy

Speciality
Code
Description
License number
State
173C00000X
Reflexologist
MT009570
GA
225700000X
Massage Therapist
Primary
MT9570
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MT009570
LICENSED MASSAGE THERAPST
GA
Enumeration date
09/06/2016
Last updated
09/06/2016
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