Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 2087 | NM |
NPI | 1710285127 |
---|---|
Provider Name | Donna M Springstead |
First Address | Albuquerque, NM 87102-2500 |
Second Address | Albuquerque, NM 87102-2500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2011 |
Last Update Date | 09/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
APPLIED FOR | (02) | NM |