Provider Demographics
NPI:1750676847
Name:MCMASTER, SANDRA KIM (OTR)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:KIM
Last Name:MCMASTER
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 1:2 CARILITO SPRINGS ROAD
Mailing Address - Street 2:
Mailing Address - City:TIJERAS
Mailing Address - State:NM
Mailing Address - Zip Code:87059
Mailing Address - Country:US
Mailing Address - Phone:505-249-0828
Mailing Address - Fax:
Practice Address - Street 1:1931 ALVARADO DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-5162
Practice Address - Country:US
Practice Address - Phone:505-249-0828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM933225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist