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Individual

MRS. ELSA A PAEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1905 W PIERCE ST, CARLSBAD, NM 88220-4025
(505) 885-3161
(505) 885-3250
Mailing address
PO BOX 796, DEXTER, NM 88230-0796
(505) 734-5628
(505) 748-6160

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1898
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
EP1905
NM
Enumeration date
08/07/2007
Last updated
08/07/2007
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