Malachi Jacoby Segura, OTR/L
Occupational Therapist in Albuquerque, NM. Individual provider (NPI-1).
NPI number1407428303
StatusActive
Last updated in NPPESOct 7, 2024
Details
- NPI
- 1407428303
- Entity type
- Individual (NPI-1)
- Name
- Malachi Jacoby Segura
- Credential
- OTR/L
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 12, 2021
- Certification date
- Oct 7, 2024
- Last updated
- Oct 7, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | OT-2023-0089 | NM | Yes |
Practice location
3311 Candelaria Rd Ne Ste EAlbuquerque, NM 87107-1952
Phone 505-200-9962
Mailing address
11317 Baja Dr NeAlbuquerque, NM 87111-2609
Phone 505-429-8841
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