Provider Demographics
NPI:1760127849
Name:DEE, LEAH NICOLE (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:NICOLE
Last Name:DEE
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2678 BROOKE WILLOW BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-1893
Mailing Address - Country:US
Mailing Address - Phone:865-324-9838
Mailing Address - Fax:
Practice Address - Street 1:1060 LOVELL RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-3060
Practice Address - Country:US
Practice Address - Phone:865-324-9838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10810225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist