Provider Demographics
NPI:1891840971
Name:MUNOZ, BARBARA ANN (MT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 GALLEGOS RD SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-4631
Mailing Address - Country:US
Mailing Address - Phone:505-883-1212
Mailing Address - Fax:505-872-2917
Practice Address - Street 1:3321 CANDELARIA RD NE STE 120
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1969
Practice Address - Country:US
Practice Address - Phone:505-883-1212
Practice Address - Fax:505-872-2917
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4955225700000X, 174400000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM4955OtherOTHER