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General NPI Number Information
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NPI Number | 1942430558
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Entity Type | Individual
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Provider Name | CHRISTIE DESIMONE L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 07/16/2009
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Provider Practice Location Address
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Address Line | 2653 SAGEBRUSH DR SUITE 230
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City | FLOWER MOUND
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State | TX
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Zip | 75028-2733
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Country | US
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Telephone | 214-998-8222
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 WEST FM 407 SUITE 201-337
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City | LEWISVILLE
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State | TX
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Zip | 75077-2183
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Country | US
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Telephone | 214-998-8222
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT104316
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License Number State | TX
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