Individual
MYRIAH KOLEDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2954 RODEO PARK DR W, SANTA FE, NM 87505-6351
(505) 424-0131
(505) 424-1299
Mailing address
PO BOX 6100, SANTA FE, NM 87502-6100
(505) 424-0131
(505) 424-1299
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2678
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N4536
—
NM
Enumeration date
04/07/2010
Last updated
06/08/2011
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