Individual provider · Type 1 NPI
Shawan Latrell Maybank, MASSAGE THERAPIST
Massage Therapist · Charlotte, NC
NPI number
1912631896
Active
Practice location
709 International Dr
Charlotte, NC 28270-6973
Mailing address
740 Gates Mills Dr
Fort Mill, SC 29708-7609
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | 13630 (NC) |
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 1912631896
Shawan Latrell Maybank, MASSAGE THERAPIST's National Provider Identifier is 1912631896, issued on Jul 15, 2022. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Charlotte, NC. The record was last updated on Jul 15, 2022.