Individual
MRS. LYDIA JOY ALLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMT
Contact information
Practice address
2933 29TH AVE. S., MINNEAPOLIS, MN 55406
(651) 757-6071
Mailing address
2145 FORD PKWY, SAINT PAUL, MN 55116-1900
(651) 757-6071
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20140002939
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20140002939
MASSAGE THERAPY
—
05
—
20140002939
—
MN
Enumeration date
06/15/2018
Last updated
06/15/2018
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