Individual
MARIA ANN NICOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT-6498
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MAE 2071
MASSAGE ESTABLISHMENT LICENSE
HI
01
—
MAT-6498
MASSAGE THERAPIST LICENSE
HI
Enumeration date
06/04/2013
Last updated
06/04/2013
Update your record
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