Stephen Branch

Individual provider Active NPI Day Training/Habilitation Specialist · Belen, NM

NPI 1245502467 · NPPES record last updated Feb 3, 2012

Key facts

NPI
1245502467
Entity type
Individual (NPI type 1)
Primary specialty
Day Training/Habilitation Specialist 373H00000X
Practice address
816 La Luz Dr
Belen, NM 87002-3343
Phone
(505) 450-3920
NPI assigned
Feb 3, 2012
Sex
Male
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X Yes

Addresses

Primary practice location

816 La Luz Dr
Belen, NM 87002-3343

Mailing address

816 La Luz Dr
Belen, NM 87002-3343
Phone (505) 450-3920

Other providers in Belen, NM

All providers in Belen, NM · Day Training/Habilitation Specialist in New Mexico

Sources for this page

Verify at the official NPI Registry.