Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MT048720 | TX |
NPI | 1013277011 |
---|---|
Provider Name | Chemeka Nicole Alexander-Davis |
First Address | Houston, TX 77054-2662 |
Second Address | Houston, TX 77054-2662 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2012 |
Last Update Date | 23/05/2012 |