Individual
MS. LARISSA LEE RENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, MMP
Contact information
Practice address
2025 S DAVIS CIR, MESA, AZ 85210-6706
(602) 577-9984
Mailing address
2025 S DAVIS CIR, MESA, AZ 85210-6706
(602) 577-9984
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-13323
AZ
Other
Enumeration date
04/04/2011
Last updated
04/04/2011
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