Provider Demographics
NPI:1114307410
Name:HARCROW, ANDRIANNA KIRSTEN (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:ANDRIANNA
Middle Name:KIRSTEN
Last Name:HARCROW
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4661 S GARRISON ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-1015
Mailing Address - Country:US
Mailing Address - Phone:720-275-9159
Mailing Address - Fax:303-948-8549
Practice Address - Street 1:4661 S GARRISON ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-1015
Practice Address - Country:US
Practice Address - Phone:720-275-9159
Practice Address - Fax:303-948-8549
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0016805174400000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist