Fayola Trineice Wilson, LMT | |
906 Fagan Drive, Unit 6-b, Hammond, LA 70403-5807 | |
(985) 318-0662 | |
Not Available |
Full Name | Fayola Trineice Wilson |
---|---|
Gender | Female |
Speciality | Massage Therapist |
Location | 906 Fagan Drive, Hammond, Louisiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851846968 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225700000X | Massage Therapist | LA5480 (Louisiana) | Primary |
302R00000X | Health Maintenance Organization | LMT5480 (Louisiana) | Secondary |
Mailing Address | Practice Location Address |
---|---|
Fayola Trineice Wilson, LMT 906 Fagan Drive, Unit 6-b, Hammond, LA 70403-5807 Ph: (985) 318-0662 | Fayola Trineice Wilson, LMT 906 Fagan Drive, Unit 6-b, Hammond, LA 70403-5807 Ph: (985) 318-0662 |
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