Provider Demographics
NPI:1588084115
Name:BARELA, JOSIE MARIE (ATC)
Entity type:Individual
Prefix:
First Name:JOSIE
Middle Name:MARIE
Last Name:BARELA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 MISSOURI AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-5111
Mailing Address - Country:US
Mailing Address - Phone:575-523-8080
Mailing Address - Fax:575-523-8861
Practice Address - Street 1:2445 MISSOURI AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-5111
Practice Address - Country:US
Practice Address - Phone:575-523-8080
Practice Address - Fax:575-523-8861
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5682255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer