Individual
MARY SIMON ELLENDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1107 POINT ST, HOUMA, LA 70360-4748
(985) 873-0002
(985) 873-0002
Mailing address
1107 POINT ST, HOUMA, LA 70360-4748
(985) 873-0002
(985) 873-0002
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LA4148
LA
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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