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Individual

KAREN DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9719 CANDELARIA RD NE # 20945, ALBUQUERQUE, NM 87111-9211
(505) 977-5904
Mailing address
7112 PAN AMERICAN EAST FWY NE UNIT 97, ALBUQUERQUE, NM 87109-4217

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
IHQQ7SPH35
NM
Enumeration date
02/15/2020
Last updated
02/15/2020
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