Individual
TANYA ELAINE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
810 E 21ST ST, SUITE 6A, CLOVIS, NM 88101-4442
(575) 763-9517
Mailing address
810 E 21ST ST, SUITE 6A, CLOVIS, NM 88101-4442
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2502
NM
Other
Enumeration date
12/01/2008
Last updated
12/01/2008
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