Healthcare Provider Details

I. General information

NPI: 1699267435
Provider Name (Legal Business Name): MARIA TERESA BILBAO RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2018
Last Update Date: 06/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 PERKINS DR STE B
LAS CRUCES NM
88005-3248
US

IV. Provider business mailing address

331 TRUMAN ST NE
ALBUQUERQUE NM
87108-1318
US

V. Phone/Fax

Practice location:
  • Phone: 575-526-6682
  • Fax:
Mailing address:
  • Phone: 575-640-8798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: