Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MT113492 | TX |
NPI | 1003169426 |
---|---|
Provider Name | Veronica Benitez |
First Address | Little Elm, TX 75068-7325 |
Second Address | Little Elm, TX 75068-7325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2012 |
Last Update Date | 17/05/2013 |