Barbara A Deluca, LMHC, LMT

Individual provider Active NPI Massage Therapist · Grants, NM

NPI 1053506394 · NPPES record last updated Jun 10, 2008

Key facts

NPI
1053506394
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
LMT 2903 (NM)
Practice address
625 Kingman Ave Apt B
Box 66
Grants, NM 87020-4104
Phone
(505) 699-2254
NPI assigned
Sep 10, 2007
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

LicenseStateTypeSpecialty
0091361NMMDMental Health Counselor
2903NMMDReflexologist
LMT 2903NMMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X LMT 2903 NM Yes
Mental Health Counselor 101YM0800X 0091361 NM
Reflexologist 173C00000X 2903 NM

Addresses

Primary practice location

625 Kingman Ave Apt B
Box 66
Grants, NM 87020-4104

Mailing address

PO Box 66
Grants, NM 87020-0066
Phone (505) 699-2254

Other providers in Grants, NM

All providers in Grants, NM · Massage Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.