Provider Demographics
NPI:1144937079
Name:WILSON, ALMONYONNA KENYETTE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MS
First Name:ALMONYONNA
Middle Name:KENYETTE
Last Name:WILSON
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:ALMONYONNA
Other - Middle Name:KENYETTE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MASSAGE THERAPISTS
Mailing Address - Street 1:7151 W INDIAN SCHOOL RD APT 2111
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85033-3163
Mailing Address - Country:US
Mailing Address - Phone:480-386-4287
Mailing Address - Fax:
Practice Address - Street 1:3001 W INDIAN SCHOOL RD STE 312A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-4111
Practice Address - Country:US
Practice Address - Phone:480-750-9588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-23194225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist