Healthcare Provider Details

I. General information

NPI: 1588157317
Provider Name (Legal Business Name): MICHAEL VEILLEUX MS, OTR/L, CTAT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2018
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 PINERIDGE RUN
LAS CRUCES NM
88012-6020
US

IV. Provider business mailing address

4011 PINERIDGE RUN
LAS CRUCES NM
88012-6020
US

V. Phone/Fax

Practice location:
  • Phone: 917-716-9931
  • Fax:
Mailing address:
  • Phone: 917-716-9931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT3935
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: