Healthcare Provider Details

I. General information

NPI: 1992535181
Provider Name (Legal Business Name): BRISSA ROJO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2024
Last Update Date: 08/03/2024
Certification Date: 08/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 MED PARK DR
LAS CRUCES NM
88005-3236
US

IV. Provider business mailing address

700 E CROSBY AVE
EL PASO TX
79902-4417
US

V. Phone/Fax

Practice location:
  • Phone: 575-523-7243
  • Fax:
Mailing address:
  • Phone: 915-300-4770
  • 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: