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Individual

ANGILLO MENTOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICENSED THERAPIST

Contact information

Practice address
900 E SIX FORKS RD UNIT 160, RALEIGH, NC 27604-1819
(516) 445-6921
Mailing address
900 E SIX FORKS RD UNIT 160, RALEIGH, NC 27604-1819
(516) 445-6921

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21756
NC

Other

Enumeration date
10/11/2024
Last updated
10/11/2024
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