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Individual

AMANDA ELIZABETH MAPLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
460 SAINT MICHAELS DR STE 1205, SANTA FE, NM 87505-8605
(505) 490-6160
Mailing address
1677 CERRO GORDO RD UNIT 2B, SANTA FE, NM 87501-6148
(505) 946-8577

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT8690
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10626764900
NM
Enumeration date
12/19/2020
Last updated
12/19/2020
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