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General NPI Number Information
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NPI Number | 1366433450
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Entity Type | Individual
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Provider Name | ELIZABETH A. DILLARD MS, OTR, L
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Gender | Female
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Dates
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Enumeration Date | 10/29/2005
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 3815 OSUNA RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4430
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Country | US
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Telephone | 505-508-0505
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Fax | 505-312-8414
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Provider Business Mailing Address
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Address Line | 7 WYLIE LN
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City | SANDIA PARK
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State | NM
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Zip | 87047-7913
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Country | US
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Telephone | 505-508-0505
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Fax | 505-312-8414
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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 | MT-2024-0084
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT423
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License Number State | NM
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