Individual
MRS. STEPHANIE MARIE LASTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HHP, LMT
Contact information
Practice address
33319 LILAC RD, VALLEY CENTER, CA 92082-3213
(760) 419-2878
Mailing address
PO BOX 3412, ESCONDIDO, CA 92033-3412
(760) 419-2878
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11243
CA
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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