Individual
NICOLLE' RUTH CAFFEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT ART NMT PNF
Contact information
Practice address
5720 WATAUGA RD, WATAUGA, TX 76148-3081
(682) 808-1611
Mailing address
6448 HIGH LAWN TER, WATAUGA, TX 76148-1415
(682) 808-1611
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MT133642
TX
246ZA2600X
Medical Art Specialist/Technologist
Primary
451042-09
CO
246ZA2600X
Medical Art Specialist/Technologist
451042-09
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
06/07/2022
Last updated
06/07/2022
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