Individual
VANESSA MACIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2900 BRISTOL ST STE J102, COSTA MESA, CA 92626-7918
(949) 392-6490
Mailing address
2900 BRISTOL ST STE J102, COSTA MESA, CA 92626-7918
(949) 392-6490
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
82492
CA
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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