Provider Demographics
NPI:1386764843
Name:ARAKI, KATHY T (LMT)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:T
Last Name:ARAKI
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 1:11000 SPAIN RD NE STE E
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-1895
Mailing Address - Country:US
Mailing Address - Phone:505-271-6911
Mailing Address - Fax:
Practice Address - Street 1:11000 SPAIN RD NE STE E
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-1895
Practice Address - Country:US
Practice Address - Phone:505-271-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM#3659225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist