MR. Jamal Laronne Douglas, LMT CLT

NPI #1255158556 in Southlake, Texas

Provider Information

NPI Number: 1255158556
Entity Type: Individual
Name: MR. Jamal Laronne Douglas, LMT CLT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT CLT
Enumeration Date: Sep 26, 2024
Last Updated: Sep 26, 2024

Practice Location

Address: 2757 E SOUTHLAKE BLVD
Address 2: SUITE 110
City: Southlake
State: Texas
ZIP Code: 76092
Phone: (682) 688-5534

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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