Healthcare Provider Details

I. General information

NPI: 1992123780
Provider Name (Legal Business Name): TAOS MUNCIPAL SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 03/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 CAMINO DE LA PLACITA
TAOS NM
87571-5951
US

IV. Provider business mailing address

727 NAVAJO RD
HAGERMAN NM
88232-9717
US

V. Phone/Fax

Practice location:
  • Phone: 575-737-6115
  • Fax:
Mailing address:
  • Phone: 575-626-0172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JANE M HENSON
Title or Position: OCCUPATIONAL THERAPIST ASSISTANT
Credential: COTA-L
Phone: 575-626-0172