Provider Demographics
NPI:1528716206
Name:BARRAZA, VICTORIA H (LMT)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:H
Last Name:BARRAZA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 CENTRAL AVE SE STE 231
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-4640
Mailing Address - Country:US
Mailing Address - Phone:505-373-8768
Mailing Address - Fax:505-433-7954
Practice Address - Street 1:600 CENTRAL AVE SE STE 231
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-4640
Practice Address - Country:US
Practice Address - Phone:505-373-8768
Practice Address - Fax:505-433-7954
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-12
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMT8917225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist