Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 5866 | NM |
NPI | 1013158518 |
---|---|
Provider Name | Eva Maria Lipton-Ormand |
First Address | Albuquerque, NM 87110-5026 |
Second Address | Albuquerque, NM 87110-5026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2009 |
Last Update Date | 12/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5866 | NM LMT LICENSE NUMBER (01) | NM |