Macaela Julie Gomez, MOTR/L

Individual provider Active NPI Occupational Therapist · Tierra Amarilla, NM

NPI 1255853149 · NPPES record last updated Jul 12, 2017

Key facts

NPI
1255853149
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
3674 (NM)
Practice address
PO Box 10
Tierra Amarilla, NM 87575-0010
Phone
(575) 588-7297
Fax
(575) 588-0359
NPI assigned
Jul 12, 2017
Sex
Female
Sole proprietor
No

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
3674NMMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3674 NM Yes

Addresses

Primary practice location

PO Box 10
Tierra Amarilla, NM 87575-0010

Mailing address

PO Box 812
Chama, NM 87520-0812
Phone (970) 749-7001

Other providers in Tierra Amarilla, NM

All providers in Tierra Amarilla, NM · Occupational Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.