Provider Demographics
NPI:1790043669
Name:ARNOLD, KATHLEEN MARIE (CNMT)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MARIE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:CNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2080 FAIRBURN RD
Mailing Address - Street 2:STE. G
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1064
Mailing Address - Country:US
Mailing Address - Phone:678-213-4266
Mailing Address - Fax:
Practice Address - Street 1:2080 FAIRBURN RD
Practice Address - Street 2:STE. G
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1064
Practice Address - Country:US
Practice Address - Phone:678-213-4266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT002868225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist