Image, Marie Stella Bravante
Image, Marie Stella Bravante is an individual health care provider with primary practice located at 300 N Kentucky Ave , Roswell NM 88201-4636. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Image, Marie Stella Bravante can be contacted via phone (505) 627-0192.Contact Information
Primary practice address
300 N Kentucky Ave
Roswell NM 88201-4636
Phone: (505) 627-0192
Fax: (505) 627-2544
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 2153 | New Mexico |
Profile Details
| NPI number | 1336291855 |
|---|---|
| LBN Legal business name | Image, Marie Stella Bravante |
| Credentials | OTR L |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 17th, 2007 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336291855 | NPPES |
| New Mexico | MEDICAID | 78300070 |
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