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General NPI Number Information
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NPI Number | 1114100302
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Entity Type | Individual
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Provider Name | LUDMILA REINA
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Gender | Female
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 8201 GOLF COURSE RD NW C-2A
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-5842
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Country | US
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Telephone | 505-349-1491
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 21ST ST SE STE 8
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City | RIO RANCHO
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State | NM
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Zip | 87124-4030
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Country | US
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Telephone | 505-249-5591
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 4497
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License Number State | NM
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