Individual provider · Type 1 NPI

Stephane Lea Jackson, LMT, CCT

Massage Therapist · Atlanta, GA

NPI number 1255955464 Active

Practice location

1770 Old Spring House Ln Ste 114
Atlanta, GA 30338-6213

Call (770) 806-9048 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMT007289 (GA)

Massage Therapist: 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.

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About NPI 1255955464

Stephane Lea Jackson, LMT, CCT's National Provider Identifier is 1255955464, issued on Jun 3, 2020. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Atlanta, GA. The record was last updated on Jun 3, 2020.