Provider Demographics
NPI:1104611375
Name:NAVARRETE, VICTORIA (OTR)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:NAVARRETE
Suffix:
Gender:
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 SAMARITAN DR STE 101-A
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-1170
Mailing Address - Country:US
Mailing Address - Phone:575-592-2088
Mailing Address - Fax:
Practice Address - Street 1:2550 SAMARITAN DR STE 101-A
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-1170
Practice Address - Country:US
Practice Address - Phone:575-592-2088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMOT22048225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist