Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MT9540 | NM |
NPI | 1003577842 |
---|---|
Provider Name | Ms. Rebecca E Hayes |
First Address | Taos, NM 87571-7231 |
Second Address | Tres Piedras, NM 87577 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2022 |
Last Update Date | 05/01/2022 |