Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT3352 | NM |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT3352 | NM |
NPI | 1710542709 |
---|---|
Provider Name | Effie Pulford |
First Address | Albuquerque, NM 87108-1301 |
Second Address | Albuquerque, NM 87108-1301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2019 |
Last Update Date | 11/08/2020 |