Individual
KELLY JOANN NEWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, PLT
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MT100223
TX
247200000X
Other Technician
Primary
ZP13539
TX
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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