Provider Demographics
NPI:1225176092
Name:ARMIJO, YVONNE KATHRYN (COTA)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:KATHRYN
Last Name:ARMIJO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6232 DONA LINDA PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-3719
Mailing Address - Country:US
Mailing Address - Phone:505-899-5804
Mailing Address - Fax:
Practice Address - Street 1:4308 CARLISLE BLVD NE
Practice Address - Street 2:STE. 209
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4856
Practice Address - Country:US
Practice Address - Phone:505-828-0232
Practice Address - Fax:505-823-1051
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1345224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant