Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MT 101676 | TX |
NPI | 1013386515 |
---|---|
Provider Name | Alisa Sakal |
First Address | North Richland Hills, TX 76180-6494 |
Second Address | North Richland Hills, TX 76180-6494 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2015 |
Last Update Date | 15/09/2015 |