Heather Michelle Obrien Daugherty, LMT
Individual provider Active NPI Massage Therapist · Disney, OK
NPI 1447958772 · NPPES record last updated Feb 16, 2023
Key facts
- NPI
- 1447958772
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 192453 (OK)
- Practice address
- 337 N Johnson St.
Disney, OK 74340 - Phone
- (417) 669-4637
- NPI assigned
- Feb 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9235 | AR | MD | Massage Therapist |
| 192453 | OK | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 9235 | AR | |
| Massage Therapist | 225700000X | 192453 | OK | Yes |
Addresses
Primary practice location
337 N Johnson St.
Disney, OK 74340
Mailing address
PO Box 711
Langley, OK 74350-0711
Phone (417) 669-4637
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.