Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT3696 | NM |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT3696 | NM |
NPI | 1588220826 |
---|---|
Provider Name | Beverly Nicole Apodaca |
First Address | Albuquerque, NM 87109-3510 |
Second Address | Albuquerque, NM 87109-3510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2019 |
Last Update Date | 25/10/2020 |