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General NPI Number Information
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NPI Number | 1326272436
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Entity Type | Individual
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Provider Name | ALYIAH DOUGHTY D.O.M., L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 05/05/2009
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Last Update Date | 05/05/2009
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Provider Practice Location Address
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Address Line | 968 CAMINO DE CHELLY
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City | SANTA FE
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State | NM
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Zip | 87505-6264
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Country | US
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Telephone | 505-501-5095
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 5514
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City | SANTA FE
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State | NM
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Zip | 87502-5514
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Country | US
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Telephone | 505-501-5095
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 229
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 494
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License Number State | NM
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