Provider Demographics
NPI:1053094219
Name:HRABAK, ALYSSA (MT)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:HRABAK
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7638 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80030-4549
Mailing Address - Country:US
Mailing Address - Phone:303-483-8266
Mailing Address - Fax:
Practice Address - Street 1:12380 W 64TH AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-4016
Practice Address - Country:US
Practice Address - Phone:303-467-5337
Practice Address - Fax:303-467-1131
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0017286225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist