Healthcare Provider Details

I. General information

NPI: 1629985296
Provider Name (Legal Business Name): TEA TIME THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARQUETTE AVE NW STE 1200
ALBUQUERQUE NM
87102-5312
US

IV. Provider business mailing address

2009 MONACO CT
ARLINGTON TX
76010-4715
US

V. Phone/Fax

Practice location:
  • Phone: 505-385-6431
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: VYVIAN NGUYEN
Title or Position: OWNER
Credential:
Phone: 505-385-6431