Individual
MS. DEANNA L WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1755 LEON RD, 3321, JACKSONVILLE, FL 32246-8682
(904) 413-2692
Mailing address
1755 LEON RD, 3321, JACKSONVILLE, FL 32246-8682
(904) 413-2692
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
67010
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
67010
LMT
FL
Enumeration date
03/25/2013
Last updated
03/25/2013
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