Provider Demographics
NPI:1164757480
Name:JONES-GONZALES, PAMELA JEAN (CMT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JEAN
Last Name:JONES-GONZALES
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 FOX DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80260-6898
Mailing Address - Country:US
Mailing Address - Phone:720-252-0284
Mailing Address - Fax:
Practice Address - Street 1:8801 FOX DR
Practice Address - Street 2:SUITE 203
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80260-6898
Practice Address - Country:US
Practice Address - Phone:720-252-0284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4452225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist