Provider Demographics
NPI:1831587880
Name:FINO, DONATELLA (LMT, CDT)
Entity type:Individual
Prefix:MS
First Name:DONATELLA
Middle Name:
Last Name:FINO
Suffix:
Gender:F
Credentials:LMT, CDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 30TH ST
Mailing Address - Street 2:#220-I
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1088
Mailing Address - Country:US
Mailing Address - Phone:203-803-3027
Mailing Address - Fax:
Practice Address - Street 1:1800 30TH ST
Practice Address - Street 2:#220-I
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1088
Practice Address - Country:US
Practice Address - Phone:203-803-3027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0017055225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist