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Individual

MISS MAKAYLA ELIZABETH MAE TODD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
3720 CHURCH ROCK ST, GALLUP, NM 87301-4572
(505) 722-2261
Mailing address
1107 SOULARD ST APT C, SAINT LOUIS, MO 63104-3451
(574) 309-7973

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2025-0013
NM
225X00000X
Occupational Therapist

Other

Enumeration date
05/17/2022
Last updated
01/24/2025
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