Doctor Name: | WANDA NERENE HOLDER |
NPI Number: | 1003144916 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICENSE MASSAGE THER |
License Number: | MT010527 |
Business Practice Address: | 322 W 7th Ave Suite C Corsicana, TX - 751106402 |
Business Phone Number: | 9038722756 |
Business Fax Number: | |
Mailing Address: | 2005 W Collin St, CORSICANA |
State: | TX |
Postal Code: | 751104242 |
Phone Number: | 9038741703 |
Fax Number: | |
NPI Enumeration Date: | 12/04/2009 |
NPI Last Update Date: | 05/17/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT010527 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |