Individual
LARISSA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
16831 1/2 ALGONQUIN ST, HUNTINGTON BEACH, CA 92649-3890
(714) 393-0007
Mailing address
16831 1/2 ALGONQUIN ST, HUNTINGTON BEACH, CA 92649-3890
(714) 393-0007
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9284
CA
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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