Healthcare Provider Details

I. General information

NPI: 1699684498
Provider Name (Legal Business Name): RITA E CAVICCHIA R-DMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

466 TOWNSEND AVE
COLUMBUS OH
43223-1826
US

IV. Provider business mailing address

466 TOWNSEND AVE
COLUMBUS OH
43223-1826
US

V. Phone/Fax

Practice location:
  • Phone: 614-371-2303
  • Fax:
Mailing address:
  • Phone: 614-371-2303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225600000X
TaxonomyDance Therapist
License NumberR-DMT3180
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: