Individual
BRONWYN K WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1201 ATRISCO DR SW, ATRISCO ES, ALBUQUERQUE, NM 87105-3550
(505) 877-2772
Mailing address
1201 ATRISCO DR SW, ATRISCO ES, ALBUQUERQUE, NEW MEXICO 87105
(505) 877-2772
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
029
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NONE ASSIGNED
—
NM
Enumeration date
02/02/2010
Last updated
02/02/2010
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