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General NPI Number Information
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NPI Number | 1568227619
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Entity Type | Individual
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Provider Name | ANA-ALICIA O'BRIEN MOT
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Gender | Female
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Dates
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Enumeration Date | 02/19/2024
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 415 CEDAR ST SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-3927
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Country | US
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Telephone | 505-224-7020
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Fax | 505-224-7023
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Provider Business Mailing Address
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Address Line | 8415 SONOMA VALLEY RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-2627
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Country | US
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Telephone | 505-250-0249
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT3216
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License Number State | NM
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