Provider Demographics
NPI:1720528177
Name:JAOUEN, DEBORAH (LMT,)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:JAOUEN
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 1:327 PARK DR
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-4137
Mailing Address - Country:US
Mailing Address - Phone:970-930-0088
Mailing Address - Fax:
Practice Address - Street 1:410 20TH ST
Practice Address - Street 2:SUITE #204
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4271
Practice Address - Country:US
Practice Address - Phone:970-930-0088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-05
Last Update Date:2017-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003441225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist