Provider Demographics
NPI:1588157317
Name:VEILLEUX, MICHAEL (MS, OTR/L, CTAT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:VEILLEUX
Suffix:
Gender:M
Credentials:MS, OTR/L, CTAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 HIGH ST SE APT 3
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-3946
Mailing Address - Country:US
Mailing Address - Phone:505-750-2414
Mailing Address - Fax:
Practice Address - Street 1:2400 WELLESLEY DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1812
Practice Address - Country:US
Practice Address - Phone:505-766-9361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist