Individual
DIEDRA MICHELLE NICOLETTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA39156
Contact information
Practice address
801 TURNER ST, CLEARWATER, FL 33756-5633
(727) 313-2882
Mailing address
PO BOX 4851, CLEARWATER, FL 33758-4851
(727) 313-2882
(727) 313-9566
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA39156
FL
Other
Enumeration date
07/31/2009
Last updated
10/29/2024
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