Provider Demographics
NPI:1144598848
Name:SCHREIBER, LINDA L (MST)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:SCHREIBER
Suffix:
Gender:F
Credentials:MST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 CUSTER'S LAST STAND
Mailing Address - Street 2:
Mailing Address - City:ALTO
Mailing Address - State:NM
Mailing Address - Zip Code:88312
Mailing Address - Country:US
Mailing Address - Phone:575-336-2841
Mailing Address - Fax:
Practice Address - Street 1:149 CUSTER'S LAST STAND
Practice Address - Street 2:
Practice Address - City:ALTO
Practice Address - State:NM
Practice Address - Zip Code:88312
Practice Address - Country:US
Practice Address - Phone:575-336-2841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5233173C00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist