Healthcare Provider Details

I. General information

NPI: 1699015305
Provider Name (Legal Business Name): PATRICIA T MOLLOY-SAWYER M.S, CCC-A, F-AAA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMMY SAWYER M.S. CCC-A, F-AAA

II. Dates (important events)

Enumeration Date: 02/18/2013
Last Update Date: 02/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 CORRALES RD NW SUITE I
ALBUQUERQUE NM
87114-9254
US

IV. Provider business mailing address

10700 CORRALES RD NW SUITE I
ALBUQUERQUE NM
87114-9254
US

V. Phone/Fax

Practice location:
  • Phone: 505-890-0003
  • Fax: 505-890-3330
Mailing address:
  • Phone: 505-890-0003
  • Fax: 505-890-3330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number5270
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: