Healthcare Provider Details

I. General information

NPI: 1891840971
Provider Name (Legal Business Name): BARBARA ANN MUNOZ MT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 CANDELARIA RD NE STE 120
ALBUQUERQUE NM
87107-1969
US

IV. Provider business mailing address

1501 GALLEGOS RD SW
ALBUQUERQUE NM
87105-4631
US

V. Phone/Fax

Practice location:
  • Phone: 505-883-1212
  • Fax: 505-872-2917
Mailing address:
  • Phone: 505-883-1212
  • Fax: 505-872-2917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number4955
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: