Individual
MARY CRANE ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5501 TIOGA RD NW, ALBUQUERQUE, NM 87120-2350
(505) 301-0815
Mailing address
5501 TIOGA RD NW, ALBUQUERQUE, NM 87120-2350
(505) 301-0815
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2090
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24428051
—
NM
Enumeration date
09/20/2006
Last updated
02/21/2012
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