Nicole Elizabeth Luckey, L.M.T., E.M.T.
Massage Therapist in Coventry, CT. Individual provider (NPI-1).
NPI number1871181990
StatusActive
Last updated in NPPESJan 5, 2021
Details
- NPI
- 1871181990
- Entity type
- Individual (NPI-1)
- Name
- Nicole Elizabeth Luckey
- Credential
- L.M.T., E.M.T.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 5, 2021
- Certification date
- Jan 5, 2021
- Last updated
- Jan 5, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 10726 | CT | Yes |
Practice location
44 Forest RdCoventry, CT 06238-2920
Phone 860-377-4413
Mailing address
44 Forest RdCoventry, CT 06238-2920
Phone 860-377-4413
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