Lila Denise Fajardo, OTR
Individual provider Active NPI Occupational Therapist · Bayard, NM
NPI 1295898633 · NPPES record last updated Aug 22, 2018
Key facts
- NPI
- 1295898633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 3673 (NM)
- Practice address
- 900 Central Ave
Bayard, NM 88023 - Phone
- (575) 537-4000
- NPI assigned
- Dec 18, 2006
- 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 |
|---|---|---|---|
| 3673 | NM | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3673 | NM | Yes |
Addresses
Primary practice location
900 Central Ave
Bayard, NM 88023
Mailing address
4211 N Silver St
Silver City, NM 88061-7415
Phone (575) 534-9110
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 452 | Medicaid | NM |
Other providers in Bayard, NM
- Sharon A Brown
- Alfred Chavez Jr.
- Cobre Consolidated Schools
- Lisa Ellen Crowner
- Cindy Cruz
- Brandon I Ferguson
- Katherine G Fletcher
- Fort Bayard Medical Center
- Yvette Gonzales
- Angie O Guerra
All providers in Bayard, NM · Occupational Therapist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2018. 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.