Provider Demographics
NPI:1144806381
Name:HANSELIN, RACHAEL KAY (LMT)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:KAY
Last Name:HANSELIN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:KAY
Other - Last Name:PRIBIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3350 PEORIA ST
Mailing Address - Street 2:SUITE 190
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010
Mailing Address - Country:US
Mailing Address - Phone:303-365-4646
Mailing Address - Fax:720-638-1541
Practice Address - Street 1:3350 PEORIA ST
Practice Address - Street 2:SUITE 190
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010
Practice Address - Country:US
Practice Address - Phone:303-365-4646
Practice Address - Fax:720-638-1541
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0021907225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist