Provider Demographics
NPI:1245116201
Name:PHELPS, JANET R (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:R
Last Name:PHELPS
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:RENEE
Other - Last Name:MONTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MASSAGE THERAPIST
Mailing Address - Street 1:911 E 86TH ST STE 5
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1840
Mailing Address - Country:US
Mailing Address - Phone:317-447-9774
Mailing Address - Fax:
Practice Address - Street 1:911 E 86TH ST STE 5
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1840
Practice Address - Country:US
Practice Address - Phone:317-447-9774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INMT21907041225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty