Healthcare Provider Details

I. General information

NPI: 1073447710
Provider Name (Legal Business Name): BRANDY PARMER MOTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 N RICHARDSON AVE
ROSWELL NM
88201-4920
US

IV. Provider business mailing address

1707 E GALLINA RD
ROSWELL NM
88201-8967
US

V. Phone/Fax

Practice location:
  • Phone: 575-622-6260
  • Fax:
Mailing address:
  • Phone: 575-420-1013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-2026-0088
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: