Gonzales, Ivyrose
Gonzales, Ivyrose is an sole proprietor health care provider with primary practice located at 2727 San Pedro Dr Ne Ste 116, Albuquerque NM 87110-3364. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is her primary health care specialty. Gonzales, Ivyrose can be contacted via phone (505) 350-3069.Contact Information
Primary practice address
2727 San Pedro Dr Ne Ste 116
Albuquerque NM 87110-3364
Phone: (505) 350-3069
Fax: (505) 508-2305
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | ||
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 0805 | New Mexico |
Profile Details
| NPI number | 1750538807 |
|---|---|
| LBN Legal business name | Gonzales, Ivyrose |
| Credentials | MOTR/L,ATC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 20th, 2008 |
| Last updated | Mar 14th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750538807 | NPPES |
| New Mexico | MEDICAID | 93985312 |
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