Individual
JEDIDIAH PIENIADZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9923 HANNETT AVE NE, ALBUQUERQUE, NM 87112-4042
(505) 363-0921
Mailing address
12507 ELAINE PL NE # L, ALBUQUERQUE, NM 87112-3625
(505) 363-0921
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3222
NM
Other
Enumeration date
08/05/2014
Last updated
03/02/2025
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