Individual
MRS. KELLI THOMPSON HAMMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
630 LANCASTER DR, ARROYO GRANDE, CA 93420
(805) 704-2723
Mailing address
630 LANCASTER DR, ARROYO GRANDE, CA 93420
(805) 704-2723
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
46726
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46726
CMT LICENSE
CA
Enumeration date
09/12/2018
Last updated
09/12/2018
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