Irina Sels Campbell, LMT

Individual provider Active NPI Massage Therapist · El Prado, NM

NPI 1417202086 · NPPES record last updated Jul 19, 2012

Key facts

NPI
1417202086
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
6907 (NM)
Practice address
3 Verdolaga Road
El Prado, NM 87529
Phone
(575) 613-3133
NPI assigned
Jul 19, 2012
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
6907NMMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 6907 NM Yes

Addresses

Primary practice location

3 Verdolaga Road
El Prado, NM 87529

Mailing address

PO Box 2198
Ranchos de Taos, NM 87557-2198
Phone (575) 613-3133

Other providers in El Prado, NM

All providers in El Prado, NM · Massage Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.