Provider Demographics
NPI:1679334064
Name:LOUGHREY, NADINE (OTR/L)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:LOUGHREY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:NADYA
Other - Middle Name:
Other - Last Name:LOUGHREY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2405 MORROW RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2519
Mailing Address - Country:US
Mailing Address - Phone:512-569-9390
Mailing Address - Fax:
Practice Address - Street 1:135 MADISON ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1238
Practice Address - Country:US
Practice Address - Phone:505-333-9337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMOT3502225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist