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1104955764
MIRANDA WALENTA
ALBUQUERQUE, NM
NPI
1104955764
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Former Name
MIRANDA HEETER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: NM 2183)
Enumeration Date
2007-03-02
Last Update Date
2007-07-08
Business Address
-- MIRANDA WALENTA
4216 BALLOON PARK RD NE
ALBUQUERQUE, NM 87109-5801
Phone number: 505-344-5470
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Mailing Address
-- MIRANDA WALENTA
2385 CAMINO PINTORES
SANTA FE, NM 87505-5290
Phone number: 505-730-9514
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