Provider Demographics
NPI:1972250835
Name:HAYWARD, TAMARA (LMT)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:HAYWARD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10990 E 16TH AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-2446
Mailing Address - Country:US
Mailing Address - Phone:720-320-8218
Mailing Address - Fax:
Practice Address - Street 1:11059 E BETHANY DR STE 298
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2672
Practice Address - Country:US
Practice Address - Phone:303-210-2466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0016109225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist