Provider Demographics
NPI:1447556832
Name:CARRUTHERS, ESTEE SONNIE (OTR)
Entity Type:Individual
Prefix:
First Name:ESTEE
Middle Name:SONNIE
Last Name:CARRUTHERS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-5111
Mailing Address - Country:US
Mailing Address - Phone:575-523-8080
Mailing Address - Fax:575-523-8861
Practice Address - Street 1:2445 MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-5111
Practice Address - Country:US
Practice Address - Phone:575-523-8080
Practice Address - Fax:575-523-8861
Is Sole Proprietor?:No
Enumeration Date:2011-02-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2450225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist