Individual
TERRENA GRACE VIGIL BRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1001 YALE BLVD, ALBUQUERQUE, NM 87106
(303) 704-2361
Mailing address
1001 YALE BLVD, ALBUQUERQUE, NM 87106
(303) 704-2361
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
7402
AZ
225X00000X
Occupational Therapist
Primary
OT3919
NM
Other
Enumeration date
03/22/2018
Last updated
08/17/2020
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