IndividualActive
Ellyn Medrano, COTA/L
NPI 1487164125 · Contractor · Albuquerque, NM
Provider details
- NPI number
- 1487164125
- Entity type
- Individual
- Primary specialty
- ContractorOther Service Providers
- Credential
- COTA/L
- Sex
- Female
- Sole proprietor
- No
- License
- 3813 (NM)
Specialties & taxonomies
Other Service Providers
Practice location
8016 Petroglyph Ave Nw
Albuquerque, NM 87120-6558
Phone: (505) 228-5050
Fax: (505) 214-5009
Approximate (ZIP-level) locationGet directions
Mailing address
8016 Petroglyph Ave Nw
Albuquerque, NM 87120-6558
Registry dates
- Enumerated
- 2017-10-09
- Last updated
- 2017-10-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.