Provider Demographics
NPI:1548668403
Name:MAAT, AKUA TWO HAWK W RENEE
Entity type:Individual
Prefix:
First Name:AKUA
Middle Name:TWO HAWK W RENEE
Last Name:MAAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31333 NEUMA DR
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-3096
Mailing Address - Country:US
Mailing Address - Phone:888-431-7325
Mailing Address - Fax:
Practice Address - Street 1:15030 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-7034
Practice Address - Country:US
Practice Address - Phone:888-431-7325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-09
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57526225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist