Individual
AMANDA VACCARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1005 LUJAN HILL RD, LAS CRUCES, NM 88007-6304
(575) 523-4573
Mailing address
4066 SENECA DR, LAS CRUCES, NM 88005-0826
(575) 642-2188
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
NM
225X00000X
Occupational Therapist
Primary
OT4552
NM
Other
Enumeration date
02/02/2022
Last updated
12/07/2023
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