Healthcare Provider Details

I. General information

NPI: 1164858668
Provider Name (Legal Business Name): RAMONA P TAPIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 LA MORADA NW
ALBUQUERQUE NM
87120-1765
US

IV. Provider business mailing address

7500 LA MORADA NW
ALBUQUERQUE NM
87120-1765
US

V. Phone/Fax

Practice location:
  • Phone: 505-836-7706
  • Fax:
Mailing address:
  • Phone: 505-836-7706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberM-3933
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: