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General NPI Number Information
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NPI Number | 1962912857
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Entity Type | Individual
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Provider Name | BRITNEY MARIE MORALES
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Gender | Female
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Dates
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Enumeration Date | 10/04/2017
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Last Update Date | 10/04/2017
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Provider Practice Location Address
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Address Line | 119 LUNA ST SE
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City | LOS LUNAS
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State | NM
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Zip | 87031-6814
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Country | US
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Telephone | 505-865-1102
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 GIBSON BLVD SE APT 1073
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-3355
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Country | US
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Telephone | 915-526-6165
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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 | 3806
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License Number State | NM
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