Individual
TARA MONROE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
1609 JACK NICKLAUS DR, BELEN, NM 87002-5926
(505) 859-0098
Mailing address
1609 JACK NICKLAUS DR, BELEN, NM 87002-5926
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3487
NM
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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