Provider Demographics
NPI:1972474070
Name:LAGER, MELORA L
Entity type:Individual
Prefix:
First Name:MELORA
Middle Name:L
Last Name:LAGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5123 MIRADA DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-5736
Mailing Address - Country:US
Mailing Address - Phone:505-270-3316
Mailing Address - Fax:
Practice Address - Street 1:5123 MIRADA DR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-5736
Practice Address - Country:US
Practice Address - Phone:505-270-3316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-13
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMBRC-2011-320809171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach