Provider Demographics
NPI:1023733748
Name:MAHONEY, JENALEE MARIE (ND)
Entity type:Individual
Prefix:DR
First Name:JENALEE
Middle Name:MARIE
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2134 MUNJOR RD
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:KS
Mailing Address - Zip Code:67671-9619
Mailing Address - Country:US
Mailing Address - Phone:785-766-3453
Mailing Address - Fax:
Practice Address - Street 1:11791 W 112TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2755
Practice Address - Country:US
Practice Address - Phone:913-214-6536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath