Individual
JEANA CORLEEN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MMT, CLT, CNHP
Contact information
Practice address
2621 W MAIN ST STE 9, RUSSELLVILLE, AR 72801-2551
(501) 690-3306
Mailing address
50 CHRISTMAS DR, CASA, AR 72025-7514
(501) 233-6269
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8302
AR
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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