Amanda Anastasia Dupas, LMT, CMMT

Individual provider Active NPI Massage Therapist · Bossier City, LA

NPI 1306132584 · NPPES record last updated Jun 25, 2011

Key facts

NPI
1306132584
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
LA4863 (LA)
Practice address
1914 Citizens Bank Dr
Bossier City, LA 71111-3423
Phone
(318) 780-6560
NPI assigned
Jun 25, 2011
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
LA4863LAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X LA4863 LA Yes

Addresses

Primary practice location

1914 Citizens Bank Dr
Bossier City, LA 71111-3423

Mailing address

1914 Citizens Bank Dr
Bossier City, LA 71111-3423
Phone (318) 780-6560

Other providers in Bossier City, LA

All providers in Bossier City, LA · Massage Therapist in Louisiana

Sources for this page

Verify at the official NPI Registry.