Healthcare Provider Details

I. General information

NPI: 1982928941
Provider Name (Legal Business Name): ERIKA ANNE ABERG LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2010
Last Update Date: 03/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 TUNNEL SPRINGS RD BACK HOUSE
PLACITAS NM
87043-8829
US

IV. Provider business mailing address

PO BOX 485
PLACITAS NM
87043-0485
US

V. Phone/Fax

Practice location:
  • Phone: 505-771-3729
  • Fax:
Mailing address:
  • Phone: 505-771-3729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number6503
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: