Individual
LORENA DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
610 N VIRGINIA AVE, ROSWELL, NM 88201-6316
(575) 622-4206
Mailing address
300 N KENTUCKY AVE, ROSWELL, NM 88201-4636
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
2959
NM
225X00000X
Occupational Therapist
Primary
OT20250124
NM
Other
Enumeration date
01/07/2014
Last updated
07/23/2025
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