Healthcare Provider Details

I. General information

NPI: 1144806381
Provider Name (Legal Business Name): RACHAEL KAY HANSELIN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHAEL KAY PRIBIL

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 PEORIA ST SUITE 190
AURORA CO
80010
US

IV. Provider business mailing address

3350 PEORIA ST SUITE 190
AURORA CO
80010
US

V. Phone/Fax

Practice location:
  • Phone: 303-365-4646
  • Fax: 720-638-1541
Mailing address:
  • Phone: 303-365-4646
  • Fax: 720-638-1541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0021907
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: