Healthcare Provider Details

I. General information

NPI: 1063229391
Provider Name (Legal Business Name): FRANCESCA PEARL ASCENZI LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 12/11/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 STATE HIGHWAY 150 SUITE 7
EL PRADO NM
87529-1589
US

IV. Provider business mailing address

P.O. BOX 1589
EL PRADO NM
87529-1589
US

V. Phone/Fax

Practice location:
  • Phone: 575-776-1117
  • Fax: 575-776-1119
Mailing address:
  • Phone: 575-776-1117
  • Fax: 575-776-1119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT8210
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: