| Doctor Name: | MISS SUSAN ANN VELARDE |
| NPI Number: | 1376685545 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 12000 Stone Lake Drive Dulce, NM - 87528 |
| Business Phone Number: | 5057597246 |
| Business Fax Number: | |
| Mailing Address: | Po Box 804, DULCE |
| State: | NM |
| Postal Code: | 875280804 |
| Phone Number: | 5057597246 |
| Fax Number: | |
| NPI Enumeration Date: | 02/13/2007 |
| NPI Last Update Date: | 06/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246ZI1000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Specialist/Technologist, Other |
| Taxonomy Specialization: | Illustration, Medical |
| Taxonomy Definition: | |