Healthcare Provider Details

I. General information

NPI: 1366964132
Provider Name (Legal Business Name): JOHN GARRET SCHOOLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 CAMINO SANTA ANA
SANTA FE NM
87505-3683
US

IV. Provider business mailing address

PO BOX 273
EMBUDO NM
87531-0273
US

V. Phone/Fax

Practice location:
  • Phone: 505-385-7866
  • Fax:
Mailing address:
  • Phone: 505-385-7866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT4615
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: