Provider Demographics
NPI:1013233089
Name:RAWLINSON, AMANDA JYOTI (LMT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:JYOTI
Last Name:RAWLINSON
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 1:80 KACHINA DR
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-4316
Mailing Address - Country:US
Mailing Address - Phone:928-282-7614
Mailing Address - Fax:
Practice Address - Street 1:80 KACHINA DR
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-4316
Practice Address - Country:US
Practice Address - Phone:928-282-7614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-02885P225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist