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General NPI Number Information
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NPI Number | 1598815151
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Entity Type | Organization
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Legal Business Name | ARROYO CHAMISO PEDIATRIC REHABILITATION
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 871 DON CUBERO AVE
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City | SANTA FE
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State | NM
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Zip | 87505
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Country | US
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Telephone | 505-989-9635
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Fax |
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Provider Business Mailing Address
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Address Line | 871 DON CUBERO AVE
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City | SANTA FE
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State | NM
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Zip | 87505
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Country | US
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Telephone | 505-989-9635
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Fax |
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Authorized Official
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Title or Position | SPEECH AND LANGUAGE PATHOLOGIST
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Name | DEBORAH POLLARD VAN HECKE
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Credential | MA, CCC SLP
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Telephone | 505-995-4860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 491
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License Number State | NM
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