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NPI Code Detail

MEDICARE: THELMA BRUSUELAS

MEDICARE:   THELMA  BRUSUELAS
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
1104100000XSocial WorkerSWB-2026-0108NM
2224Z00000XOccupational Therapy Assistant2579NM

General Provider Information

NPI Number : 1376967315
Entity Type Code : Individual
Provider Name (Legal Business Name) : THELMA BRUSUELAS
Provider Business Mailing Address
First Line : 2810 N SWAN ST
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-5853
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2810 N SWAN ST
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-5853
Country : US
Telephone Number : 575-956-2043
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2014
Last Update Date : 03/04/2026

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Directions to “ THELMA BRUSUELAS ” Practice Location

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