Provider Demographics
NPI:1700130549
Name:APRENDAMOS INTERVENTION TEAM
Entity Type:Organization
Organization Name:APRENDAMOS INTERVENTION TEAM
Other - Org Name:ESPERANZA CHILDREN'S THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-526-6682
Mailing Address - Street 1:301 PERKINS DR STE B
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3248
Mailing Address - Country:US
Mailing Address - Phone:575-526-6682
Mailing Address - Fax:575-523-7254
Practice Address - Street 1:1080 MED PARK DR STE A
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-3226
Practice Address - Country:US
Practice Address - Phone:575-647-3773
Practice Address - Fax:575-647-3777
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APRENDAMOS INTERVENTION TEAM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5144235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty