Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 3694 | NM |
NPI | 1891300133 |
---|---|
Provider Name | Julianna Nacion |
First Address | Albuquerque, NM 87122-2735 |
Second Address | Albuquerque, NM 87108-5180 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2020 |
Last Update Date | 14/09/2020 |