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General NPI Number Information
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NPI Number | 1841058708
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Entity Type | Organization
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Legal Business Name | AHA THERAPIES, LLC
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Dates
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Enumeration Date | 03/06/2024
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 123 HOME ADDRESS
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City | ALBUQUERQUE
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State | NM
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Zip | 87153-3161
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Country | US
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Telephone | 505-697-9071
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 53161
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City | ALBUQUERQUE
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State | NM
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Zip | 87153-3161
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Country | US
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Telephone | 505-697-9071
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | TARA SORENSEN
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Credential | LMSW
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Telephone | 505-697-9071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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