Individual
TOMACITA TEDESCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
604 ZUNI STREET, TAOS, NM 87571
(505) 310-1703
Mailing address
PO BOX 3071, TAOS, NM 87571-3071
(505) 310-1703
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2495
NM
Other
Enumeration date
04/16/2013
Last updated
04/16/2013
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