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General NPI Number Information
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NPI Number | 1508287608
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Entity Type | Individual
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Provider Name | HEATHER DANNIELLE ROBERTS LMT,MMP
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Gender | Female
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Dates
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Enumeration Date | 12/17/2013
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Last Update Date | 12/17/2013
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Provider Practice Location Address
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Address Line | 840 PINNACLE CT BUILDING 11 SUITE 103
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City | MESQUITE
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State | NV
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Zip | 89027-3303
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Country | US
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Telephone | 435-229-9705
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Fax |
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Provider Business Mailing Address
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Address Line | 1327 W 360 N
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City | ST GEORGE
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State | UT
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Zip | 84770-4614
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Country | US
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Telephone | 435-229-9705
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | NVMT.628
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 352467-4701
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License Number State | UT
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