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NPI Code Detail

MEDICARE: MAURA SHEA O'DOCHARTY

MEDICARE: MAURA SHEA O'DOCHARTY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1215760913
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAURA SHEA O'DOCHARTY
Provider Business Mailing Address
First Line : 10899 MONTGOMERY BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87111-3926
Country : US
Telephone Number : 505-460-7103
Fax Number :
Provider Business Practice Location Address
First Line : 10899 MONTGOMERY BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87111-3926
Country : US
Telephone Number : 505-460-7103
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2024
Last Update Date : 08/20/2024

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Directions to “ MAURA SHEA O'DOCHARTY ” Practice Location

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