Jacklyn Joan-Marie Hansen
Individual provider Active NPI Massage Therapist · Walled Lake, MI
NPI 1386599181 · NPPES record last updated Feb 27, 2026
Key facts
- NPI
- 1386599181
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 7501016862 (MI)
- Practice address
- 831 N Pontiac TRL Lot 70
Walled Lake, MI 48390-3206 - Phone
- (313) 633-4974
- NPI assigned
- Feb 27, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 7501016862 | MI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackie'S Myomassology Healing and Wellness LMT LLC | Massage Therapist | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 7501016862 | MI | Yes |
Addresses
Primary practice location
831 N Pontiac TRL Lot 70
Walled Lake, MI 48390-3206
Mailing address
831 N Pontiac TRL Lot 70
Walled Lake, MI 48390-3206
Phone (313) 633-4974
Other providers in Walled Lake, MI
- Lauren Haelterman
- Jamie L Hafke
- Taleb Radwan Hage
- Reema Hakim
- John Salvatore Halmaghi
- Emma Mary Harris
- Steven Hechtman
- Carl Hendricks
- Karen Hendricks
- Henry Ford Health System
All providers in Walled Lake, MI · Massage Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2026. 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.