Healthcare Provider Details

I. General information

NPI: 1679424758
Provider Name (Legal Business Name): ALAYA MARIE LOVATO
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10899 MONTGOMERY BLVD NE STE B
ALBUQUERQUE NM
87111-3935
US

IV. Provider business mailing address

12611 SINGING ARROW AVE SE
ALBUQUERQUE NM
87123-3787
US

V. Phone/Fax

Practice location:
  • Phone: 505-460-7103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: