Provider Demographics
NPI:1629641816
Name:SANCHEZ, TEIA NICOLE
Entity Type:Individual
Prefix:
First Name:TEIA
Middle Name:NICOLE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 SANTA ELENA ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-2844
Mailing Address - Country:US
Mailing Address - Phone:505-227-9169
Mailing Address - Fax:
Practice Address - Street 1:6900 SANTA ELENA ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-2844
Practice Address - Country:US
Practice Address - Phone:505-227-9169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician