Healthcare Provider Details

I. General information

NPI: 1801009600
Provider Name (Legal Business Name): YVETTE MARIE ARELLANO DOM, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9412 INDIAN SCHOOL, NE
ALBUQUERQUE NM
87112
US

IV. Provider business mailing address

PO BOX 40678
ALBUQUERQUE NM
87196
US

V. Phone/Fax

Practice location:
  • Phone: 505-269-0925
  • Fax:
Mailing address:
  • Phone: 505-269-0925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number842
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: