Provider Demographics
NPI:1053138487
Name:JANSSON-MACKEY, KATARINA (MSC)
Entity type:Individual
Prefix:
First Name:KATARINA
Middle Name:
Last Name:JANSSON-MACKEY
Suffix:
Gender:F
Credentials:MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 ITHACA DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6332
Mailing Address - Country:US
Mailing Address - Phone:843-384-6138
Mailing Address - Fax:
Practice Address - Street 1:1260 ITHACA DR
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6332
Practice Address - Country:US
Practice Address - Phone:843-384-6138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
Yes171400000XOther Service ProvidersHealth & Wellness Coach