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General NPI Number Information
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NPI Number | 1366261760
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Entity Type | Individual
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Provider Name | DANA S BRESCIA MOTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/03/2024
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 400 EDITH BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-2510
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Country | US
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Telephone | 505-764-2024
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Fax |
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Provider Business Mailing Address
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Address Line | 5809 NATALIE AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-1315
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Country | US
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Telephone | 505-463-1863
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT-2024-0136
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License Number State | NM
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