Dawn Kelly
Individual provider Active NPI Massage Therapist · Sterling, AK
NPI 1134460710 · NPPES record last updated Mar 21, 2013
Key facts
- NPI
- 1134460710
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 1117 (MT)
- Practice address
- 34401 Grizzly Lane
Sterling, AK 99672-0346 - Phone
- (907) 398-1108
- NPI assigned
- Mar 7, 2013
- 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 |
|---|---|---|---|
| 1117 | MT | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 1117 | MT | Yes |
Addresses
Primary practice location
34401 Grizzly Lane
Sterling, AK 99672-0346
Mailing address
34401 Grizzly Lane
Sterling, AK 99672
Other providers in Sterling, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2013. 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.