Provider Demographics
NPI:1457046401
Name:DUMAEL, CELINE ANNE VALERE ABRICO
Entity Type:Individual
Prefix:
First Name:CELINE ANNE VALERE
Middle Name:ABRICO
Last Name:DUMAEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 CARDENAS DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-3723
Mailing Address - Country:US
Mailing Address - Phone:505-328-0470
Mailing Address - Fax:
Practice Address - Street 1:625 CARDENAS DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-3723
Practice Address - Country:US
Practice Address - Phone:505-328-0470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4870225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist