Katherine Jankowski

Individual provider Active NPI Massage Therapist · Flagler Beach, FL

NPI 1972901908 · NPPES record last updated Jun 28, 2021

Key facts

NPI
1972901908
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA76395 (FL)
Practice address
2561 Moody Blvd Ste 100
Flagler Beach, FL 32136-4404
Phone
(386) 569-5972
Fax
(386) 693-4308
NPI assigned
Dec 8, 2014
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MA76395FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Kitty Den Massage Therapist Current
since Jul 4, 2021
Accepting new patients

Locations

2561 Moody Blvd
Ste 100
Flagler Beach, FL 32136
Phone (386) 264-0852

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA76395 FL Yes

Addresses

Primary practice location

2561 Moody Blvd Ste 100
Flagler Beach, FL 32136-4404

Mailing address

2561 Moody Blvd Ste 100
Flagler Beach, FL 32136-4404
Phone (386) 569-5972

Other providers in Flagler Beach, FL

All providers in Flagler Beach, FL · Massage Therapist in Florida

Sources for this page

Verify at the official NPI Registry.