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Individual

BRENDA TRYON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MOTR/L

Contact information

Practice address
10604 MIERA DR NW, ALBUQUERQUE, NM 87114
(505) 730-7058
Mailing address
7108 BRINDISI PL NW, ALBUQUERQUE, NM 87114-1332
(505) 730-7058

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3706
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3706
NM STATE
NM
Enumeration date
12/30/2017
Last updated
07/07/2024
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