Latifa Kwayis Anderson

Individual provider Active NPI Massage Therapist · Metairie, LA

NPI 1104548338 · NPPES record last updated Sep 14, 2022

Key facts

NPI
1104548338
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
LA2918 (LA)
Practice address
2628 Metairie Lawn Dr Ste 202
Metairie, LA 70002-6141
Phone
(504) 236-8648
NPI assigned
Sep 14, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LA2918LAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X LA2918 LA Yes

Addresses

Primary practice location

2628 Metairie Lawn Dr Ste 202
Metairie, LA 70002-6141

Mailing address

2628 Metairie Lawn Dr Ste 202
Metairie, LA 70002-6141
Phone (504) 236-8648

Other providers in Metairie, LA

All providers in Metairie, LA · Massage Therapist in Louisiana

Sources for this page

Verify at the official NPI Registry.