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General NPI Number Information
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NPI Number | 1497815658
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Entity Type | Organization
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Legal Business Name | SENSATIONAL THERAPY INC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7620 VISTA ALTA RD NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-3724
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Country | US
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Telephone | 505-220-7009
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Fax | 505-899-1481
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Provider Business Mailing Address
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Address Line | 7620 VISTA ALTA RD NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-3724
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Country | US
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Telephone | 505-220-7009
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Fax | 505-899-1481
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. MARJORIE RUTH QUINE SMITH
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Credential | MA OTRL
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Telephone | 505-220-7009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1155
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License Number State | NM
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