Individual
SUSAN M. ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT/L
Contact information
Practice address
5323 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1302
(505) 883-7222
Mailing address
PO BOX 25704, ALBUQUERQUE, NM 87125-0704
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT4232
NM
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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