Individual
LISA YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA L
Contact information
Practice address
301 PERKINS DR STE B, LAS CRUCES, NM 88005-3248
(505) 523-7243
Mailing address
851 W ASH ST, DEMING, NM 88030-3449
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2074
NM
Other
Enumeration date
05/21/2007
Last updated
03/31/2011
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