Individual
MRS. HOLLY GUENETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL CHT
Contact information
Practice address
2538 CAMINO ENTRADA STE 300, SANTA FE, NM 87507-4927
(505) 424-1239
(888) 746-4761
Mailing address
2538 CAMINO ENTRADA STE 300, SANTA FE, NM 87507-4927
(505) 424-1239
(888) 746-4761
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT 2585
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890472301
—
FL
01
—
891854600
MEDICAID
FL
01
—
Z096U
BCBS PROVIDER NUMBER
FL
Enumeration date
10/10/2006
Last updated
11/28/2012
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