Provider Demographics
NPI:1336340827
Name:MORALES, FRANKIE JOE (COTA,L)
Entity Type:Individual
Prefix:
First Name:FRANKIE
Middle Name:JOE
Last Name:MORALES
Suffix:
Gender:M
Credentials:COTA,L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 AUSTIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:TRUTH OR CONSEQUENCES
Mailing Address - State:NM
Mailing Address - Zip Code:87901-2707
Mailing Address - Country:US
Mailing Address - Phone:505-956-3063
Mailing Address - Fax:
Practice Address - Street 1:1400 N SILVER ST
Practice Address - Street 2:
Practice Address - City:TRUTH OR CONSEQUENCES
Practice Address - State:NM
Practice Address - Zip Code:87901-1957
Practice Address - Country:US
Practice Address - Phone:505-956-3063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2168224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant