Doctor Name: | JENNIFER DOHERTY |
NPI Number: | 1033413216 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RMT, MBA |
License Number: | MT-7646 |
Business Practice Address: | 4755 N Academy Blvd Colorado Springs, CO - 809184255 |
Business Phone Number: | 7192719663 |
Business Fax Number: | |
Mailing Address: | 138 Creekside Ln, Apt. 104 COLORADO SPRINGS |
State: | CO |
Postal Code: | 809063267 |
Phone Number: | 7192719663 |
Fax Number: | |
NPI Enumeration Date: | 01/03/2011 |
NPI Last Update Date: | 01/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT-7646 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |