Doctor Name: | MS. NEOMA STOLTZFUS-DOVER |
NPI Number: | 1083005482 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSAA |
License Number: | 0169311 |
Business Practice Address: | 630 Haines Ave Nw Albuquerque, NM - 871021226 |
Business Phone Number: | 5052685611 |
Business Fax Number: | |
Mailing Address: | 7217 Prairie Rd Ne, ALBUQUERQUE |
State: | NM |
Postal Code: | 871091817 |
Phone Number: | 5054104974 |
Fax Number: | |
NPI Enumeration Date: | 02/07/2015 |
NPI Last Update Date: | 02/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 0169311 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |