Individual
MR. HARRISON ERASTE GUILLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MOTR/L
Contact information
Practice address
5531 AMISTAD RD NE, ALBUQUERQUE, NM 87111-1549
(505) 238-9377
Mailing address
5531 AMISTAD RD NE, ALBUQUERQUE, NM 87111-1549
(505) 238-9377
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2399
NM
225XN1300X
Neurorehabilitation Occupational Therapist
2399
NM
225XP0200X
Pediatric Occupational Therapist
2399
NM
Other
Enumeration date
08/13/2008
Last updated
08/13/2008
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