NPI 1255615290 · live from the CMS NPI Registry
Jackie Linn Brasseaux, LMT
Massage Therapist in Baton Rouge, LA. National Provider Identifier 1255615290, active.
NPI record
| NPI | 1255615290 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 1857 Wooddale Blvd, Baton Rouge, LA 70806 |
| Practice phone | 225-927-8160 |
| Mailing address | 1857 Wooddale Boulevard, Baton Rouge, LA 70706 |
| Enumerated | October 10, 2011 |
| Last updated | October 10, 2011 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | 4751-2 (LA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.