Individual
MS. SHAWNTINA LASHAWN NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
706 RIDGE RD, MUNSTER, IN 46321-1612
(219) 836-8892
(219) 836-2244
Mailing address
706 RIDGE RD, MUNSTER, IN 46321-1612
(219) 836-8890
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT209001009
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT209001009
LICENSE NUMBER
IN
Enumeration date
04/05/2011
Last updated
07/10/2014
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