Healthcare Provider Details

I. General information

NPI: 1316240294
Provider Name (Legal Business Name): MRS. ASHLEY RENE LOHR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2010
Last Update Date: 12/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9180 COORS BLVD NW APT 602
ALBUQUERQUE NM
87120-3112
US

IV. Provider business mailing address

9180 COORS BLVD NW APT 602
ALBUQUERQUE NM
87120-3112
US

V. Phone/Fax

Practice location:
  • Phone: 505-203-6154
  • Fax:
Mailing address:
  • Phone: 505-203-6154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: