Individual
MELODY ANN RAQUET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7124 COMMONS DR UNIT D, CHEYENNE, WY 82009-2620
(307) 635-6777
(307) 635-6780
Mailing address
7124 COMMONS DR UNIT D, CHEYENNE, WY 82009-2620
(307) 635-6777
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
OL-21-41284
WY
225X00000X
Occupational Therapist
CO260756
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21-41284
CITY LICENSE
WY
Enumeration date
09/09/2020
Last updated
09/09/2020
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