Provider Demographics
NPI:1659780666
Name:GIACOMELLI, JENNIFER (CMT, LMT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:GIACOMELLI
Suffix:
Gender:F
Credentials:CMT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6065 SIBLEY RD
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1619
Mailing Address - Country:US
Mailing Address - Phone:734-433-0697
Mailing Address - Fax:
Practice Address - Street 1:6065 SIBLEY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1619
Practice Address - Country:US
Practice Address - Phone:734-433-0697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist