Provider Demographics
NPI:1962710111
Name:VALDEZ, MORGAN (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:MR
Other - First Name:SEAN
Other - Middle Name:
Other - Last Name:VALDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MECHANIC
Mailing Address - Street 1:4681 JOE PEAY RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-2215
Mailing Address - Country:US
Mailing Address - Phone:615-330-1040
Mailing Address - Fax:
Practice Address - Street 1:4681 JOE PEAY RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2215
Practice Address - Country:US
Practice Address - Phone:615-330-1040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMT0000003418225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist