Leticia Alcala, LMT, NCBTMB

Individual provider Active NPI Massage Therapist · Fort Mohave, AZ

NPI 1982840872 · NPPES record last updated Dec 23, 2008

Key facts

NPI
1982840872
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MT-11064 (AZ)
Practice address
5455 Hwy 95
Fort Mohave, AZ 86426
Phone
(928) 234-2087
Fax
(928) 763-6003
NPI assigned
Dec 23, 2008
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
MT-11064AZMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT-11064 AZ Yes

Addresses

Primary practice location

5455 Hwy 95
Fort Mohave, AZ 86426

Mailing address

5455 Hwy 95
Fort Mohave, AZ 86426-9227
Phone (928) 234-2087

Other providers in Fort Mohave, AZ

All providers in Fort Mohave, AZ · Massage Therapist in Arizona

Sources for this page

Verify at the official NPI Registry.