Individual
KATHLEEN SOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1415 W 2ND ST, ROSWELL, NM 88201-2013
(515) 623-2615
Mailing address
1415 W 2ND ST, ROSWELL, NM 88201-2013
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4041
NM
Other
Enumeration date
11/26/2019
Last updated
11/26/2019
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