Individual
MRS. TERI DONA WARNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
901A MARKET ST, PORTLAND, TX 78374-1727
(361) 704-6005
Mailing address
107 MELBA DR, PORTLAND, TX 78374-1433
(205) 821-1207
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT113831
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT113831
TDLR
TX
Enumeration date
07/28/2021
Last updated
07/28/2021
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