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General NPI Number Information
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NPI Number | 1629604319
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Entity Type | Individual
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Provider Name | IVONNE OLAY BOUJAOUDE
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Gender | Female
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Dates
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Enumeration Date | 03/13/2020
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 8304 CEDAR CREEK DR NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-3846
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Country | US
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Telephone | 505-307-2002
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Fax |
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Provider Business Mailing Address
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Address Line | 8304 CEDAR CREEK DR NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-3846
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Country | US
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Telephone |
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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 | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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