Individual
SHAQUANDA RAQUEL HARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10320 COTTONWOOD PARK NW, ALBUQUERQUE, NM 87114-7008
(505) 250-5204
Mailing address
205 W GLADDEN DR, FARMINGTON, NM 87401-6019
(505) 402-8187
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA4639
NM
Other
Enumeration date
07/21/2023
Last updated
07/25/2023
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