Provider Demographics
NPI:1063637593
Name:SENA, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:SENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CALLE MEDICO
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4724
Mailing Address - Country:US
Mailing Address - Phone:505-424-8777
Mailing Address - Fax:505-424-9777
Practice Address - Street 1:8 CALLE MEDICO
Practice Address - Street 2:SUITE 1
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4724
Practice Address - Country:US
Practice Address - Phone:505-424-8777
Practice Address - Fax:505-424-9777
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM027225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist