Provider Demographics
NPI:1639414709
Name:NAVARRD, MARJORIE KAY (LMT)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:KAY
Last Name:NAVARRD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:MARJORIE
Other - Middle Name:KAY
Other - Last Name:MAHACEK-SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 AINSWORTH DRIVE
Mailing Address - Street 2:SUITE A120
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-1688
Mailing Address - Country:US
Mailing Address - Phone:928-925-3131
Mailing Address - Fax:
Practice Address - Street 1:1000 AINSWORTH DRIVE
Practice Address - Street 2:SUITE A120
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-1688
Practice Address - Country:US
Practice Address - Phone:928-925-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173C00000X
AZMT-00554P225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist