Individual
MELINDA SALEM-JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCTMB, LMT, CMMT
Contact information
Practice address
2695 VAN ZANDT CR 4923, BEN WHEELER, TX 75754-4440
(903) 368-4200
Mailing address
2695 VZ COUNTY ROAD 4923, BEN WHEELER, TX 75754-4440
(903) 368-4200
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-08893
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT-116546
STATE LICENSE
TX
Enumeration date
11/17/2009
Last updated
10/02/2013
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