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General NPI Number Information
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NPI Number | 1447518428
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Entity Type | Organization
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Legal Business Name | 'THERAPY IS FUN', INC.
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Dates
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Enumeration Date | 04/27/2012
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Last Update Date | 04/27/2012
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Provider Practice Location Address
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Address Line | 13 DOS LOCOS
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City | LOS LUNAS
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State | NM
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Zip | 87031-5014
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Country | US
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Telephone | 505-620-4129
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Fax | 505-216-0897
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Provider Business Mailing Address
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Address Line | 13 DOS LOCOS
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City | LOS LUNAS
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State | NM
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Zip | 87031-5014
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Country | US
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Telephone | 505-620-4129
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Fax | 505-216-0897
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Authorized Official
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Title or Position | PRESIDENT
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Name | CINDY A. CHACON
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Credential | M.A.,CCC-SLP
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Telephone | 505-620-4129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 3285
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License Number State | NM
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