Provider Demographics
NPI:1093307506
Name:SCARLETT, BONNIE J (LMT)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:J
Last Name:SCARLETT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:BONNIE
Other - Middle Name:J
Other - Last Name:BRITTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:5259 TERRITORIAL ST
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-2744
Mailing Address - Country:US
Mailing Address - Phone:719-201-8857
Mailing Address - Fax:719-735-1156
Practice Address - Street 1:595 CHAPEL HILLS DR STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1056
Practice Address - Country:US
Practice Address - Phone:719-201-8857
Practice Address - Fax:719-735-1156
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT0007356173C00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist