Healthcare Provider Details

I. General information

NPI: 1053053785
Provider Name (Legal Business Name): ASHLEY KAY MAY LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2509 VERMONT ST NE STE D101B
ALBUQUERQUE NM
87110-3722
US

IV. Provider business mailing address

2509 VERMONT ST NE STE D101B
ALBUQUERQUE NM
87110-3722
US

V. Phone/Fax

Practice location:
  • Phone: 505-886-1807
  • Fax:
Mailing address:
  • Phone: 505-886-1807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number9570
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: