Individual
NANCY ANN WALCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1591 E LOHMAN AVE, LAS CRUCES, NM 88001-3185
(575) 650-4444
Mailing address
4338 CALLE AMARILLA, LAS CRUCES, NM 88011-1822
(575) 202-0657
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3474
NM
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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