Provider Demographics
NPI:1710429261
Name:JOLIVET, MAJ-BRITH
Entity Type:Individual
Prefix:
First Name:MAJ-BRITH
Middle Name:
Last Name:JOLIVET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4651 E RAIL N RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85739-9181
Mailing Address - Country:US
Mailing Address - Phone:520-954-1003
Mailing Address - Fax:
Practice Address - Street 1:4651 E RAIL N RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9181
Practice Address - Country:US
Practice Address - Phone:520-954-1003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-15
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-21281225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist