Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 5822 | NM |
NPI | 1003087826 |
---|---|
Provider Name | Ms. Darcy A Nicholson |
First Address | Santa Fe, NM 87507-6506 |
Second Address | Santa Fe, NM 87505-2138 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2008 |
Last Update Date | 19/03/2008 |