Individual
ANN SACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
PVS - 1574, STATE ROAD 502, SANTA FE, NM 87501
(505) 455-0801
(505) 455-3023
Mailing address
P.O.BOX 3468, POJOAQUESTATION, SANTA FE, NM 87501-0468
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
957
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
K9579
—
NM
Enumeration date
05/01/2007
Last updated
07/08/2007
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