Healthcare Provider Details

I. General information

NPI: 1497815658
Provider Name (Legal Business Name): SENSATIONAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7620 VISTA ALTA RD NW
ALBUQUERQUE NM
87114-3724
US

IV. Provider business mailing address

7620 VISTA ALTA RD NW
ALBUQUERQUE NM
87114-3724
US

V. Phone/Fax

Practice location:
  • Phone: 505-220-7009
  • Fax: 505-899-1481
Mailing address:
  • Phone: 505-220-7009
  • Fax: 505-899-1481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1155
License Number StateNM

VIII. Authorized Official

Name: MRS. MARJORIE RUTH QUINE SMITH
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MA OTRL
Phone: 505-220-7009