Provider Demographics
NPI:1265763759
Name:SIGMON MASSEY, KATHERINE WENDY (LMT)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:WENDY
Last Name:SIGMON MASSEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:WENDY
Other - Last Name:SIGMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9421 E TRAILSIDE VW
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6008
Mailing Address - Country:US
Mailing Address - Phone:602-292-5458
Mailing Address - Fax:
Practice Address - Street 1:14848 N. CAVE CREEK SUITE#29
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022
Practice Address - Country:US
Practice Address - Phone:602-292-5458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT02070P174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist