Provider Demographics
NPI:1841010378
Name:DOFFLEMEYER, SASHA TERESA (LMT)
Entity type:Individual
Prefix:MS
First Name:SASHA
Middle Name:TERESA
Last Name:DOFFLEMEYER
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 1:916 LINCOLN SQ APT G
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-4112
Mailing Address - Country:US
Mailing Address - Phone:434-222-0302
Mailing Address - Fax:
Practice Address - Street 1:916 LINCOLN SQ APT G
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-4112
Practice Address - Country:US
Practice Address - Phone:434-222-0302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.022266225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist