Virginia Nicholls Aldea, OTR/L

Individual provider Active NPI Occupational Therapist · Deming, NM

NPI 1912142316 · NPPES record last updated Dec 14, 2008

Key facts

NPI
1912142316
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
2427 (NM)
Practice address
111 N Pearl St
Deming, NM 88030-3835
Phone
(575) 544-4663
Fax
(575) 544-4665
NPI assigned
Dec 14, 2008
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
2427NMMDOptometrist
111412TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summits Healthcare, LLC Past
since Sep 24, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2427 NM Yes
Occupational Therapist 225X00000X 111412 TX

Addresses

Primary practice location

111 N Pearl St
Deming, NM 88030-3835

Mailing address

3308 Gila CT
Deming, NM 88030-8673
Phone (575) 545-1913

Other providers in Deming, NM

All providers in Deming, NM · Occupational Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.