Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | 3765 | NM |
NPI | 1013148840 |
---|---|
Provider Name | Dr. Leah Collins |
First Address | Santa Fe, NM 87505-4222 |
Second Address | Santa Fe, NM 87505-4222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2009 |
Last Update Date | 31/05/2013 |