Daphne Thayer Barrett, LMT
Individual provider Active NPI Contractor · Albuquerque, NM
NPI 1003241092 · NPPES record last updated Sep 9, 2013
Key facts
- NPI
- 1003241092
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 7312 (NM)
- Practice address
- 4263 Montgomery Blvd NE
Suite 200
Albuquerque, NM 87109-6747 - Phone
- (505) 872-3100
- NPI assigned
- Sep 9, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7312 | NM | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 7312 | NM | Yes |
Addresses
Primary practice location
4263 Montgomery Blvd NE
Suite 200
Albuquerque, NM 87109-6747
Mailing address
901 Ortega Rd NW
Los Ranchos, NM 87114-1417
Phone (505) 263-4236
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.