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General NPI Number Information
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NPI Number | 1912559857
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Entity Type | Individual
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Provider Name | CATHEY MICHELLE ALLEN LMT, BCTMB, CCM
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Gender | Female
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 39006 N 11TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85086
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Country | US
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Telephone | 314-348-0034
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Fax |
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Provider Business Mailing Address
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Address Line | 39006 N 11TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85086
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Country | US
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Telephone | 314-348-0034
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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 | 2012006451
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License Number State | MO
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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 | MT-22355
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License Number State | AZ
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