Individual
RENAE GRIEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
119 LUNA AVE, LOS LUNAS, NM 87031
(505) 865-9636
Mailing address
10823 JEWEL CAVE RD SE, ALBUQUERQUE, NM 87123-5910
(505) 239-6430
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1240
NM
Other
Enumeration date
12/20/2013
Last updated
12/20/2013
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