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Individual

NORA GANDARILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
610 W BENDER BLVD STE 1300, HOBBS, NM 88240-2241
(575) 433-2002
(888) 729-4956
Mailing address
610 W BENDER BLVD STE 1300, HOBBS, NM 88240-2241
(575) 433-2002
(888) 729-4956

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4199
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4199
NEW MEXICO COTA LICENSE
NM
Enumeration date
03/05/2021
Last updated
03/05/2021
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