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NPI Code Detail

MEDICARE: SAVANNAH NEVAEH BLAIR PEREA

MEDICARE: SAVANNAH NEVAEH BLAIR PEREA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianNM

General Provider Information

NPI Number : 1336071133
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAVANNAH NEVAEH BLAIR PEREA
Provider Business Mailing Address
First Line : 10899 MONTGOMERY BLVD NE STE B
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87111-3935
Country : US
Telephone Number : 505-460-7103
Fax Number : 505-709-1354
Provider Business Practice Location Address
First Line : 10899 MONTGOMERY BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87111-3926
Country : US
Telephone Number : 505-460-7103
Fax Number : 505-709-1354
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ SAVANNAH NEVAEH BLAIR PEREA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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