Provider Demographics
NPI:1841480910
Name:NEFF, ANTOINETTE NORINE (MT-BC)
Entity type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:NORINE
Last Name:NEFF
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 VANDEN BOSCH PKWY
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-4535
Mailing Address - Country:US
Mailing Address - Phone:505-722-4174
Mailing Address - Fax:
Practice Address - Street 1:507 VANDEN BOSCH PKWY
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-4535
Practice Address - Country:US
Practice Address - Phone:505-722-4174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist