Individual
LILA DENISE FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
900 CENTRAL AVE, BAYARD, NM 88023
(575) 537-4000
Mailing address
4211 N SILVER ST, SILVER CITY, NM 88061-7415
(575) 534-9110
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3673
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
452
—
NM
Enumeration date
12/18/2006
Last updated
08/22/2018
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