Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 7306 | NM |
NPI | 1003168717 |
---|---|
Provider Name | Ms. Amy M Naranjo |
First Address | Albuquerque, NM 87108-4601 |
Second Address | Albuquerque, NM 87108-4601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2012 |
Last Update Date | 04/10/2012 |