TANNA S WILLIS, LCMT, Massage Therapist BOISE, ID

Contact Information

TANNA S WILLIS, LCMT

1529 BELMONT ST
BOISE, ID 83725-0001

Phone: 208-426-1459
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Massage Therapist	225700000X
Student Health	261QS1000X

Indicates primary specialty

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NPI Profile & details for TANNA S WILLIS · (Female)

NPI Number	`1033551015`
Status	Active
Credentials	LCMT
Entity	Individual
Enumeration date	07/19/2013
Last updated	07/19/2013 - About 13 years ago
Sole proprietor ¹	Yes
Identifiers	ID License # 820290701 ID License # MAS-732
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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