Provider Demographics
NPI:1265949036
Name:HUCKEBY-GONZALEZ, NANCY (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:HUCKEBY-GONZALEZ
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7446 INDIAN WELLS WAY
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-4211
Mailing Address - Country:US
Mailing Address - Phone:571-449-1779
Mailing Address - Fax:
Practice Address - Street 1:2570 S COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5909
Practice Address - Country:US
Practice Address - Phone:720-277-7018
Practice Address - Fax:720-277-7018
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0014624225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist