KELLY M CAVANAUGH LMT CMLDT NPI 1073007548

NPI Information

NPI: 1073007548
Provider Name: KELLY M CAVANAUGH, LMT, CMLDT
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
425 JOLIET ST STE 212
DYER, IN
ZIP 46311
Phone: (219) 381-9772
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Kelly M Cavanaugh, LMT, CMLDT is a massage therapist in Dyer, IN. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. Kelly M Cavanaugh, LMT, CMLDT NPI is 1073007548. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

425 JOLIET ST STE 212
DYER, IN
ZIP 46311-766
Phone: (219) 381-9772

The enumeration date for this NPI number is 6/19/2018 and was last updated on 6/19/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist		MT21505529	INDIANA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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