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NPI Code Detail

MEDICARE: DIRECT THERAPY SERVICES, LLP

MEDICARE: DIRECT THERAPY SERVICES, LLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency
2235Z00000XSpeech-Language PathologistNM
3106H00000XMarriage & Family Therapist
4174400000XSpecialistNM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386753010
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIRECT THERAPY SERVICES, LLP
Provider Business Mailing Address
First Line : 301 PERKINS DR STE C
Second Line : SUITE C
City : LAS CRUCES
State : NM
Zip : 88005-3248
Country : US
Telephone Number : 575-523-7243
Fax Number : 575-525-5641
Provider Business Practice Location Address
First Line : 1090 MED PARK DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-3236
Country : US
Telephone Number : 575-523-7243
Fax Number : 575-525-5641
Authorized Official
Title or Position : OFFICE MANAGER
Name : BEATRICE SANDOVAL
Credential :
Telephone Number : 575-523-7243
Provider Enumeration Date : 08/29/2006
Last Update Date : 01/24/2017

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Directions to “DIRECT THERAPY SERVICES, LLP ” Practice Location

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