Provider Demographics
NPI:1598566010
Name:WALTERS, TABATHA MARIE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:TABATHA
Middle Name:MARIE
Last Name:WALTERS
Suffix:
Gender:
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 1:875 NOME ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-4169
Mailing Address - Country:US
Mailing Address - Phone:720-261-8081
Mailing Address - Fax:
Practice Address - Street 1:14901 E HAMPDEN AVE STE 223
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-5065
Practice Address - Country:US
Practice Address - Phone:720-921-6666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0021894225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist