Individual
PATRICA DIANE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 CAMINO ESPANOL NW, ALBUQUERQUE, NM 87107-5817
(505) 250-5204
Mailing address
280 TROSELLO RD, CORRALES, NM 87048-6104
(907) 617-5216
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3988
NM
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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