Provider Demographics
NPI:1558698308
Name:MCGHEE, FELICIA THRISHAWNA (LMT)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:THRISHAWNA
Last Name:MCGHEE
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 1:6802 N 67TH AVE APT 32206
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-9024
Mailing Address - Country:US
Mailing Address - Phone:602-202-6825
Mailing Address - Fax:
Practice Address - Street 1:6802 N 67TH AVE APT 32206
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-9024
Practice Address - Country:US
Practice Address - Phone:602-202-6825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-13
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-04407P225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist