Individual
MISTI MICHELLE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT MMP
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9674482-4701
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9674482-4701
STATE OF UTAH DEPARTMENT OF COMMERCE
UT
Enumeration date
11/28/2017
Last updated
05/29/2019
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