Healthcare Provider Details

I. General information

NPI: 1306306303
Provider Name (Legal Business Name): LEANNE MARIE STIGLER LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 03/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 N QUINLAN PARK RD STE 200
AUSTIN TX
78732-6071
US

IV. Provider business mailing address

2215 POST RD APT 2066
AUSTIN TX
78704-4345
US

V. Phone/Fax

Practice location:
  • Phone: 512-329-5500
  • Fax:
Mailing address:
  • Phone: 512-717-1460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT105802
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: