Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | LA4123 | LA |
NPI | 1003049552 |
---|---|
Provider Name | Ms. Emily A Lafitte |
First Address | Shreveport, LA 71118-2900 |
Second Address | Shreveport, LA 71105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2009 |
Last Update Date | 14/09/2011 |