Domanique Ingram
Domanique Ingram is a Massage Therapist in Longview, Texas. Licensed in Texas. Registered with an NPI since 2021.
- Licensed in
- TX
- In the registry since
- 2021
Practice location Address checks out
501 N Spur 63 Ste C1Longview, TX 75601-5010
Phone: (903) 746-6019
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Massage Therapist (primary) | Taxonomy 225700000X · Licence MT123998 (TX) |
|---|
Record details
| NPI number | 1205429180 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | February 11, 2021 |
| Last updated in NPPES | February 11, 2021 |
| Certification date | February 11, 2021 |
| Mailing address | 1203 W River Oaks Dr, Longview, TX 75604-5844 |
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