Individual
PRISCILA CARRASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 S 1ST ST, LOVINGTON, NM 88260-4829
(575) 739-2670
Mailing address
813 W GORE AVE, LOVINGTON, NM 88260-2619
(575) 631-8464
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA3608
NM
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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