Individual
DONNA EVRAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5050 PUEBLO TRL, LAS CRUCES, NM 88012-7324
(575) 626-3368
Mailing address
5050 PUEBLO TRL, LAS CRUCES, NM 88012-7324
(575) 626-3368
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2961
NM
Other
Enumeration date
10/12/2015
Last updated
10/12/2015
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