Provider Demographics
NPI:1093314650
Name:BEELIGHTFUL THERAPY PRACTICE LLC
Entity Type:Organization
Organization Name:BEELIGHTFUL THERAPY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:N
Authorized Official - Last Name:APODACA
Authorized Official - Suffix:
Authorized Official - Credentials:MOT
Authorized Official - Phone:505-715-8031
Mailing Address - Street 1:6313 BARNHART ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3510
Mailing Address - Country:US
Mailing Address - Phone:505-715-8031
Mailing Address - Fax:
Practice Address - Street 1:6313 BARNHART ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3510
Practice Address - Country:US
Practice Address - Phone:505-715-8031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty