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NPI Code Detail

MEDICARE: GAIL K BEAVER OTR/L

MEDICARE: GAIL K BEAVER OTR/L
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
1225XP0200XPediatric Occupational Therapist2712NM

General Provider Information

NPI Number : 1235578147
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAIL K BEAVER OTR/L
Provider Business Mailing Address
First Line : 1800 COPPER LOOP
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-8139
Country : US
Telephone Number : 575-524-2575
Fax Number : 575-523-1756
Provider Business Practice Location Address
First Line : 2325 NEVADA AVE
Second Line :
City : LAS CRUCES
State : NM
Zip : 88001-3902
Country : US
Telephone Number : 575-527-4900
Fax Number : 575-523-1756
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2013
Last Update Date : 06/25/2013

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Directions to “ GAIL K BEAVER OTR/L” Practice Location

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