Provider Demographics
NPI:1942878814
Name:THE KITTY DEN
Entity Type:Organization
Organization Name:THE KITTY DEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPTST
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JANKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:386-569-5972
Mailing Address - Street 1:2561 MOODY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FLAGLER BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32136-4404
Mailing Address - Country:US
Mailing Address - Phone:386-264-0852
Mailing Address - Fax:
Practice Address - Street 1:2561 MOODY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FLAGLER BEACH
Practice Address - State:FL
Practice Address - Zip Code:32136-4404
Practice Address - Country:US
Practice Address - Phone:386-569-5972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NIRVANA WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty