Provider Demographics
NPI:1629400247
Name:WINNINGHOFF, MARNIE HELEN
Entity type:Individual
Prefix:
First Name:MARNIE
Middle Name:HELEN
Last Name:WINNINGHOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 GILPIN ST
Mailing Address - Street 2:APT 4
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1646
Mailing Address - Country:US
Mailing Address - Phone:303-501-5134
Mailing Address - Fax:
Practice Address - Street 1:975 LINCOLN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2725
Practice Address - Country:US
Practice Address - Phone:303-861-6632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0005248225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist