Provider Demographics
NPI:1114566692
Name:STAMPS, VANESSA CATHERINE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:CATHERINE
Last Name:STAMPS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 PIKES PEAK DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79110-2600
Mailing Address - Country:US
Mailing Address - Phone:806-335-0633
Mailing Address - Fax:
Practice Address - Street 1:6141 W AMARILLO BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1901
Practice Address - Country:US
Practice Address - Phone:806-216-6366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT132390225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist