Individual
KASSANDRA M BAHENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
230 LANFARE PL, COLORADO SPRINGS, CO 80911-3333
(719) 755-2088
Mailing address
230 LANFARE PL, COLORADO SPRINGS, CO 80911-3333
(719) 755-2088
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
M.0009269
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7197552088
UNKNOWN
—
05
—
UNKNOWN
—
CO
Enumeration date
07/20/2022
Last updated
07/20/2022
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