MEDICARE: MARIA E VALDEZ LMT

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
1	225700000X	Massage Therapist	2860	NM

General Provider Information

NPI Number	:	1992938252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA E VALDEZ LMT

Provider Business Mailing Address
First Line	:	611 UNIVERSITY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-4247
Country	:	US
Telephone Number	:	505-220-5635
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 UNIVERSITY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-4247
Country	:	US
Telephone Number	:	505-220-5635
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2009
Last Update Date	:	01/15/2015

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Directions to “ MARIA E VALDEZ LMT” Practice Location

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