CHEYENNE TAYLER BOLENBAUGH (NPI# 1952896672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952896672 |
Entity Type | Individual |
Full Name | CHEYENNE TAYLER BOLENBAUGH |
Credential | CTRS |
Practice Address |
7537 Lee Rd Apt B Jackson MI 49201-8152 |
Practice Telephone | 5175541491 |
Mailing Telephone | 5175541491 |
Enumeration Date | 2018-06-25 |
Last Update Date | 2018-06-25 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 225800000X | Recreation Therapist | 80603 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
7537 LEE RD APT B |
City | JACKSON |
State | MI |
Zip Code | 49201-8152 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
1841827946 | Maverick Jubane | Student in an Organized Health Care Education/Training Program | Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 | 2020-03-26 |
1306486584 | Cody Williams | Technician, Other | 1001 Laurence Avenue St E, Jackson, MI 49201 | 2020-01-15 |
1720632292 | Krystie Lynn Adorjan | Speech-Language Pathologist | 1175 W Parnall Rd, Jackson, MI 49201 | 2019-08-01 |
1407412653 | Howard Franklin Tanner II | Speech-Language Pathologist | 102 East Michigan Avenue, Jackson, MI 49201 | 2019-05-14 |
1356863740 | Rima Zarar Qayyum | Speech-Language Pathologist | 4800 Firethorn Dr., Jackson, MI 49201 | 2017-07-07 |
1306384383 | Briana Nesmith | Speech-Language Pathologist | 2025 Ann Arbor Road, Jackson, MI 49201 | 2017-02-09 |
1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
1306212881 | Aisha Henderson | Social Worker | 729 West Michigan Avenue, Jackson, MI 49201 | 2015-08-19 |
Find all providers in zip 49201 |
Taxonomy Code | 225800000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Recreation Therapist |
A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. |
Notes: Source: Joel A. DeLisa and Bruce M. Gans, Rehabilitation Medicine: Principles and Practice Second Edition, J.B. Lippincott Company, Philadelphia: 1993, p. 7 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386828853 | Kelli M Jones | Recreation Therapist | 1230 Angus Drive, Jackson, WY 83001 | 2007-12-20 |
1881291383 | Regina Marie Riley | Recreation Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-10-07 |
1932727468 | Davis Mckenna Simms | Recreation Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-07-10 |
1154948222 | Tiffany Floyd | Recreation Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-07-06 |
1962029389 | Devonda Y Elliott | Recreation Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-07-01 |
1427599018 | Mark Marble | Recreation Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2017-03-15 |
1720469711 | Shalonda Knight | Recreation Therapist | 6204 N State St, Jackson, MS 39213-9731 | 2015-06-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861006728 | Tara Ann Fedewa | Recreation Therapist | 915 Laurelwood Dr, Lansing, MI 48917-7725 | 2020-09-08 |
1225651714 | Caroline Rose Marcon | Recreation Therapist | 15227 Payne Ct, Dearborn, MI 48126-3030 | 2020-05-19 |
1205469897 | Megan Groat | Recreation Therapist | 914 Lake Dr, Oxford, MI 48371-5716 | 2020-02-21 |
1215560040 | Ashley Melyn Phelps | Recreation Therapist | 6714 Northland Dr Ne, Rockford, MI 49341-9201 | 2020-02-20 |
1538708680 | Caylie Hosey | Recreation Therapist | 54749 Flamingo Dr, Shelby Twp, MI 48315-1347 | 2020-01-06 |
1205480472 | Keilahna Castillo | Recreation Therapist | 4476 Versatile Ct Sw, Wyoming, MI 49418-8773 | 2019-07-26 |
1134789514 | Cynthia Guzi | Recreation Therapist | 4469 Lutz Dr, Warren, MI 48092-1750 | 2019-06-18 |
1780244160 | Derenda Lefevre | Recreation Therapist | 3724 Noble Rd, Oxford, MI 48370-1514 | 2019-06-18 |
1407416886 | Jenna Black | Recreation Therapist | 28328 N Skye Dr, Farmington Hills, MI 48334-5335 | 2019-06-18 |
1225698608 | Carly Jane Rhodea | Recreation Therapist | 6906 Severance Rd, Cass City, MI 48726-9202 | 2019-06-18 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.