Healthcare Provider Details

I. General information

NPI: 1528172582
Provider Name (Legal Business Name): F LYNETTE HAMBY MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1617 CALLE DE ORIENTE NORTE
SANTA FE NM
87507
US

IV. Provider business mailing address

1617 CALLE DE ORIENTE NORTE
SANTA FE NM
87507
US

V. Phone/Fax

Practice location:
  • Phone: 505-471-0754
  • Fax:
Mailing address:
  • Phone: 505-471-0754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number280
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: