| Talata Nessibatou Awoussou Agoudavi, LMT | |
|
16323 Mathias Ave, Jamaica, NY 11433-3926 | |
| (347) 876-1047 | |
| Not Available |
| Full Name | Talata Nessibatou Awoussou Agoudavi |
|---|---|
| Gender | Female |
| Speciality | Massage Therapist |
| Location | 16323 Mathias Ave, Jamaica, New York |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326781410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | 032379-01 (New York) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Talata Nessibatou Awoussou Agoudavi, LMT 16323 Mathias Ave, Jamaica, NY 11433-3926 Ph: (347) 876-1047 | Talata Nessibatou Awoussou Agoudavi, LMT 16323 Mathias Ave, Jamaica, NY 11433-3926 Ph: (347) 876-1047 |
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