Doctor Name: | LISSA J SIEJA |
NPI Number: | 1760666580 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MT |
License Number: | MT046158 |
Business Practice Address: | 7201 Baker Blvd Suite C Richland Hills, TX - 761185864 |
Business Phone Number: | 8175959206 |
Business Fax Number: | 8175959139 |
Mailing Address: | 6605 Jerri Lynn Dr, WATAUGA |
State: | TX |
Postal Code: | 761482519 |
Phone Number: | 8178804300 |
Fax Number: | |
NPI Enumeration Date: | 12/28/2007 |
NPI Last Update Date: | 12/28/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT046158 |
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. |