Provider Demographics
NPI:1497815658
Name:SENSATIONAL THERAPY INC
Entity Type:Organization
Organization Name:SENSATIONAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:QUINE SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA OTRL
Authorized Official - Phone:505-220-7009
Mailing Address - Street 1:7620 VISTA ALTA RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-3724
Mailing Address - Country:US
Mailing Address - Phone:505-220-7009
Mailing Address - Fax:505-899-1481
Practice Address - Street 1:7620 VISTA ALTA RD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-3724
Practice Address - Country:US
Practice Address - Phone:505-220-7009
Practice Address - Fax:505-899-1481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1155174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM39286517Medicaid