Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | NM |
NPI | 1023567971 |
---|---|
Provider Name | Dayanara Sarahi Hernandez |
First Address | Albuquerque, NM 87112-3240 |
Second Address | Albuquerque, NM 87120-1381 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2016 |
Last Update Date | 03/10/2016 |