Individual
SHELBY R TARANGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
173 EL CAMINO CAMPO, CORRALES, NM 87048-7518
(719) 289-5766
Mailing address
3915 TUNDRA SWAN CT NW, ALBUQUERQUE, NM 87120-4113
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3872
NM
Other
Enumeration date
03/06/2018
Last updated
07/23/2019
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