Individual
JASMINE TIYA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
248 BALLENTINE ST, BAY ST LOUIS, MS 39520-4113
(228) 671-1395
Mailing address
248 BALLENTINE ST, BAY ST LOUIS, MS 39520-4113
(228) 671-1395
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2966
MS
Other
Enumeration date
06/09/2026
Last updated
06/09/2026
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