Provider Demographics
NPI:1619727500
Name:LUCIANO, MARGARET H (LMT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:H
Last Name:LUCIANO
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 1:1500 AVENIDA DE LAS AMERICAS
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-5079
Mailing Address - Country:US
Mailing Address - Phone:505-216-8066
Mailing Address - Fax:
Practice Address - Street 1:1229 S SAINT FRANCIS DR STE A
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4052
Practice Address - Country:US
Practice Address - Phone:505-216-8066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMT9098225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist