NPI 1093420028

Desirae Serene Ellison

Practitioner Massage Therapist Beckley, WV

Practice location

Address: 21 Mallard CT, Beckley, WV 25801-3615
Phone: (304) 890-8020
Fax: (681) 207-7029
Mailing address: 4714 Okey L Patteson Rd, Scarbro, WV 25917-8022

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 2018-3632 (WV)

Other Massage Therapist providers in West Virginia →

Registry record

NPI: 1093420028
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Jan 2023
Record last updated: 13 Jan 2023

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.