Provider Demographics
NPI:1134568389
Name:SEPULVEDA, ANA (REFLEXOLOGY/ REIKI)
Entity type:Individual
Prefix:MS
First Name:ANA
Middle Name:
Last Name:SEPULVEDA
Suffix:
Gender:F
Credentials:REFLEXOLOGY/ REIKI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 TELLES AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-4363
Mailing Address - Country:US
Mailing Address - Phone:575-437-5346
Mailing Address - Fax:
Practice Address - Street 1:1306 INDIAN WELLS RD
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-5685
Practice Address - Country:US
Practice Address - Phone:575-479-5105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM173C00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist
No174400000XOther Service ProvidersSpecialist