Individual
RAQUELLE S LAFOUCADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-3076
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-3076
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16604
NC
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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