Provider Demographics
NPI:1659781425
Name:BELUCHE, ANA M (LMT)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:M
Last Name:BELUCHE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 CAMINO DE CABALLO
Mailing Address - Street 2:PO BOX 1171 TAOS THERAPEUTIC MASSAGE
Mailing Address - City:RANCHOS DE TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87557-1171
Mailing Address - Country:US
Mailing Address - Phone:575-758-7912
Mailing Address - Fax:
Practice Address - Street 1:219 CAVALRY RD
Practice Address - Street 2:CENTER FOR NATURAL HEALING
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571
Practice Address - Country:US
Practice Address - Phone:575-770-8662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMLMT #7609225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist