Provider Demographics
NPI:1215072186
Name:PORTE, MARGARET SARAH (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:SARAH
Last Name:PORTE
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:MS
Other - First Name:MARGARET
Other - Middle Name:SARAH
Other - Last Name:PICCHIARINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OCCUPATIONAL THERAPI
Mailing Address - Street 1:PO BOX 213
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:NM
Mailing Address - Zip Code:88230-0213
Mailing Address - Country:US
Mailing Address - Phone:575-748-5071
Mailing Address - Fax:575-734-5331
Practice Address - Street 1:315 W WASHINGTON AVE STE 2
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-2865
Practice Address - Country:US
Practice Address - Phone:575-748-5071
Practice Address - Fax:575-734-5331
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM55808832Medicaid