Provider Demographics
NPI:1568227619
Name:O'BRIEN, ANA-ALICIA (MOT)
Entity Type:Individual
Prefix:
First Name:ANA-ALICIA
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:O'BRIEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MOT
Mailing Address - Street 1:8415 SONOMA VALLEY RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-2627
Mailing Address - Country:US
Mailing Address - Phone:505-250-0249
Mailing Address - Fax:
Practice Address - Street 1:415 CEDAR ST SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-3927
Practice Address - Country:US
Practice Address - Phone:505-224-7020
Practice Address - Fax:505-224-7023
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMOT3216225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics