Healthcare Provider Details
I. General information
NPI: 1942010285
Provider Name (Legal Business Name): JOYFULL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2025
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5700 HARPER DR NE STE 210
ALBUQUERQUE NM
87109-3541
US
IV. Provider business mailing address
2809 ALVARADO DR NE
ALBUQUERQUE NM
87110-3229
US
V. Phone/Fax
- Phone: 505-451-4049
- Fax:
- Phone: 505-208-2214
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOY
E
DAVIS
Title or Position: OWNER THERAPIST
Credential:
Phone: 505-451-4049