Provider Demographics
NPI:1912570623
Name:BRANIFF, KATHLEEN M (LMT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:BRANIFF
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:BRANIFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6200 W JEFFERSON PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-4612
Mailing Address - Country:US
Mailing Address - Phone:303-668-5497
Mailing Address - Fax:
Practice Address - Street 1:11890 W 64TH AVE # 80004
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-4324
Practice Address - Country:US
Practice Address - Phone:303-467-5337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.2783000225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist