Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 391 | NM |
NPI | 1184878506 |
---|---|
Provider Name | Patricia Cummins Siegel |
First Address | Los Ranchos, NM 87107-6608 |
Second Address | Albuquerque, NM 87109-1210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2008 |
Last Update Date | 12/11/2008 |