Provider Demographics
NPI:1881368017
Name:DELASANTOS, HEIDI (MOT)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:DELASANTOS
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 FIVE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:TIJERAS
Mailing Address - State:NM
Mailing Address - Zip Code:87059-7461
Mailing Address - Country:US
Mailing Address - Phone:505-688-9367
Mailing Address - Fax:
Practice Address - Street 1:8100 PALOMAS AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-5264
Practice Address - Country:US
Practice Address - Phone:505-821-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist