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General NPI Number Information
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NPI Number | 1871228858
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Entity Type | Individual
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Provider Name | DONNY EDWARDS
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Gender | Male
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Dates
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Enumeration Date | 07/22/2022
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 10101 LAGRIMA DE ORO RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-6022
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Country | US
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Telephone | 505-298-1231
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Fax |
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Provider Business Mailing Address
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Address Line | 10101 LGRMA ORO RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-6022
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Country | US
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Telephone | 505-298-1231
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 242558
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OT-2023-0167
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License Number State | NM
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