Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist |
NPI | 1003105925 |
---|---|
Provider Name | Mrs. Rebekah Anne Mcneil |
First Address | Walla Walla, WA 99362-2574 |
Second Address | Walla Walla, WA 99362-2574 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2011 |
Last Update Date | 31/03/2011 |