Individual
MS. TANA ELIZABETH BEVERWYK-ABOUDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPT, EIM
Contact information
Practice address
628 N RIVERSIDE DR STE C, ESPANOLA, NM 87532-2620
(505) 927-8516
Mailing address
33-A SANTA FE COUNTY ROAD 119-N, SANTA FE, NM 87506
(505) 927-8516
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
798784
NM
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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