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General NPI Number Information
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NPI Number | 1568616894
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Entity Type | Organization
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Legal Business Name | DOGWOOD THERAPY SERVICES INC
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Dates
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Enumeration Date | 11/13/2008
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Last Update Date | 10/29/2015
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Provider Practice Location Address
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Address Line | 3108 ALAMOGORDO DR NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1108
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Country | US
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Telephone | 505-433-2583
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Fax | 866-904-9976
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Provider Business Mailing Address
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Address Line | 3108 ALAMOGORDO DR NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1108
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Country | US
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Telephone | 505-433-2583
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Fax | 866-904-9976
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MELISSA Y WINKLE
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Credential | OTR/L, FAOTA
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Telephone | 505-433-2583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1775
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License Number State | NM
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