MISS KELLY JEAN MAHLA (NPI# 1356551824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356551824 |
| Entity Type | Individual |
| Full Name | MISS KELLY JEAN MAHLA |
| Credential | LLP, PTA |
| Practice Address |
55753 Serene Dr Macomb MI 48042-6164 |
| Practice Telephone | 5862163815 |
| Mailing Telephone | 5862163815 |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2012-11-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
6301013552 | MI | Behavioral Health & Social Service Providers |
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
55753 SERENE DR |
| City | MACOMB |
| State | MI |
| Zip Code | 48042-6164 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235750431 | Precision Surgery Center LLC | Clinic/Center | 22701 Hall Road, Macomb, MI 48042 | 2020-04-29 |
| 1437573177 | Michael D Pizzimenti | Physical Therapist | 23211 N 21 Mile Road, Macomb, MI 48042 | 2014-02-18 |
| 1518210707 | Kimberly Frances Hodor | Nurse Practitioner | 21840 23 Mile, Macomb, MI 48042 | 2012-10-25 |
| 1952628489 | Frank John Pugliesi | Obstetrics & Gynecology | 49730 S. Thunder Bay Circle, Macomb, MI 48042 | 2010-04-23 |
| 1053575118 | North Macomb Mrt Center LLC | Radiology | 17900 23 Mile Road, Macomb Twp, MI 48042 | 2008-07-17 |
| 1780857870 | Ryan David Vinson | Physical Therapist | 23211 21 Mile Rd, Macomb, MI 48042 | 2008-04-09 |
| 1578690889 | Michael P Nedley | Dentist | 51218 Romeo Plank Rd, Macomb Township, MI 48042 | 2007-02-27 |
| 1477697027 | Amy Hanes | Psychologist | 21592 Doral Dr, Macomb, MI 48042 | 2007-02-16 |
| 1871672055 | Jeffrey Richard Teno | Dentist | 16800 24 Mile, Suite 5, Macomb, MI 48042 | 2006-11-06 |
| 1649389123 | Rite Aid of Michigan Inc | Durable Medical Equipment & Medical Supplies | 15250 24 Mile Road, Macomb, MI 48042 | 2006-08-29 |
| Find all providers in zip 48042 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497396667 | April S Schafer | Massage Therapist | 15373 Hall Rd, Macomb, MI 48044-3841 | 2019-09-30 |
| 1144781923 | Rosanna Impemba | Massage Therapist | 16651 21 Mile Rd, Macomb, MI 48044-2603 | 2019-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629043 | Nathaniel Farnsworth Barrino | Massage Therapist | 21940 Coolidge Hwy, Oak Park, MI 48237-2811 | 2020-11-06 |
| 1376144378 | Uper, Inc | Massage Therapist | 3197 E Rocky Trl, Cedarville, MI 49719-9560 | 2020-11-05 |
| 1700487832 | Emalee Ann Behem | Massage Therapist | 7880 Vincent Rd, Croswell, MI 48422-9010 | 2020-11-04 |
| 1588264238 | Courtney Altmaier | Massage Therapist | 1175 S Smith Rd, Cedarville, MI 49719-9564 | 2020-10-30 |
| 1023617990 | Beth Andrea Schipper | Massage Therapist | 2717 104th Ave, Zeeland, MI 49464-6801 | 2020-10-22 |
| 1528667722 | Elissa Marie Stewart | Massage Therapist | 118 Minnehaha St, Roscommon, MI 48653-7118 | 2020-10-20 |
| 1881292977 | Cheyanne English | Massage Therapist | 119 Columbia Ave E Ste 12, Battle Creek, MI 49015-3765 | 2020-10-12 |
| 1063010288 | Heather R Iavelli | Massage Therapist | 220 Dumaire St, White Lake, MI 48383-2697 | 2020-10-09 |
| 1558968578 | Polly Ann Holmes | Massage Therapist | 359 W Nepessing St Ste B, Lapeer, MI 48446-2182 | 2020-10-02 |
| 1891302493 | Irene Dooley | Massage Therapist | 544 E Kirby St, Detroit, MI 48202-4121 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.