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General NPI Number Information
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NPI Number | 1922332576
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Entity Type | Individual
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Provider Name | BETTE CAROL HEGARTY LICENSED MASSAGE THE
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Gender | Female
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 09/30/2009
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Provider Practice Location Address
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Address Line | 8146 THAMES BLVD. UNIT C
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City | BOCA RATON
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State | FL
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Zip | 33433-8524
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Country | US
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Telephone | 561-654-5194
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Fax | 561-921-1644
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Provider Business Mailing Address
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Address Line | 8146-C THAMES BLVD. UNIT-C.
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City | BOCA RATON
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State | FL
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Zip | 33433-8524
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Country | US
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Telephone | 561-654-5194
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Fax | 561-921-1644
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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 | MA0020100
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License Number State | FL
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