Individual
TANISHA COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6230 MELROSE ST, DOUGLASVILLE, GA 30134-2249
(470) 782-2440
Mailing address
6230 MELROSE ST, DOUGLASVILLE, GA 30134-2249
(470) 782-2440
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT013607
GA
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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