Individual
MS. TERESA OLIVIA FALLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADN, CMT
Contact information
Practice address
726 MENDOCINO AVE, SANTA ROSA, CA 95401-4804
(707) 548-1970
(707) 867-1243
Mailing address
2665 STONY POINT RD, SANTA ROSA, CA 95407-7343
(707) 548-1970
(707) 867-1243
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
85355
CA
Other
Enumeration date
01/29/2021
Last updated
01/29/2021
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