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Individual

AMANDA FRASER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.M.T.,R.N.

Contact information

Practice address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
(505) 272-1977
Mailing address
4997 BUTTE PL NW, ALBUQUERQUE, NM 87120-4410
(505) 999-6243

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN70412
NM
225700000X
Massage Therapist
4045
NM

Other

Enumeration date
07/13/2007
Last updated
02/26/2016
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