Provider Demographics
NPI:1871697375
Name:DENTON, SHARI ANN (LMT, NMT, TPMT)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:ANN
Last Name:DENTON
Suffix:
Gender:F
Credentials:LMT, NMT, TPMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 BARBARA LOOP SE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1039
Mailing Address - Country:US
Mailing Address - Phone:505-792-2592
Mailing Address - Fax:505-792-2814
Practice Address - Street 1:4011 BARBARA LOOP SE
Practice Address - Street 2:SUITE 108
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1039
Practice Address - Country:US
Practice Address - Phone:505-792-2592
Practice Address - Fax:505-792-2814
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X, 225400000X
NM3940225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered174400000XOther Service ProvidersSpecialist
Not Answered225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist