NPI 1043561665

Tina Marie Hickson, LMT

Practitioner Massage Therapist Columbia, MD

Practice location

Address: 5525 Twin Knolls Rd Suite 321, Columbia, MD 21045-3266
Phone: (240) 459-3044
Mailing address: 9080 Moonshine Holw APT a, Laurel, MD 20723-1638

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence M04294 (MD)

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Registry record

NPI: 1043561665
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Sep 2012
Record last updated: 21 Sep 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.