Provider Demographics
NPI:1225425127
Name:TENORIO, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:TENORIO
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 1:1515 EUBANK SE
Mailing Address - Street 2:
Mailing Address - City:ABQ
Mailing Address - State:NM
Mailing Address - Zip Code:87185
Mailing Address - Country:US
Mailing Address - Phone:505-844-1866
Mailing Address - Fax:505-845-1000
Practice Address - Street 1:1515 EUBANK SE
Practice Address - Street 2:
Practice Address - City:ABQ
Practice Address - State:NM
Practice Address - Zip Code:87185
Practice Address - Country:US
Practice Address - Phone:505-844-1866
Practice Address - Fax:505-845-1000
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator