Individual
MRS. KECIA MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
505 S MAIN ST STE 249, LAS CRUCES, NM 88001-1243
(575) 527-5823
(575) 527-5886
Mailing address
505 S MAIN ST STE 249, LAS CRUCES, NM 88001-1243
(575) 527-5823
(575) 527-5886
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3389850-01
—
TX
Enumeration date
07/08/2014
Last updated
04/15/2020
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