Doctor Name: | MS. WILLOW GENEVA ANN ROBERTS |
NPI Number: | 1972901874 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.T. |
License Number: | MT.0008026 |
Business Practice Address: | 26291 Main St Conifer, CO - 804338500 |
Business Phone Number: | 3038380990 |
Business Fax Number: | |
Mailing Address: | 2759 Hidden Valley Blvd, PINE |
State: | CO |
Postal Code: | 804707989 |
Phone Number: | 3038387294 |
Fax Number: | |
NPI Enumeration Date: | 12/09/2014 |
NPI Last Update Date: | 12/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT.0008026 |
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. |