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Individual

JACQUELINE NICOLE DEEGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
15-2891 PAHOA VILLAGE RD., PAHOA, HI 96778-8214
(808) 965-6623
Mailing address
13-1233 KAHUKAI ST, PAHOA, HI 96778-8214
(808) 965-9603

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT 10071, MAE 2420
HI

Other

Enumeration date
12/03/2008
Last updated
12/03/2008
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