Provider Demographics
NPI:1992123780
Name:TAOS MUNCIPAL SCHOOLS
Entity type:Organization
Organization Name:TAOS MUNCIPAL SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HENSON
Authorized Official - Suffix:
Authorized Official - Credentials:COTA-L
Authorized Official - Phone:575-626-0172
Mailing Address - Street 1:727 NAVAJO RD
Mailing Address - Street 2:
Mailing Address - City:HAGERMAN
Mailing Address - State:NM
Mailing Address - Zip Code:88232-9717
Mailing Address - Country:US
Mailing Address - Phone:575-626-0172
Mailing Address - Fax:
Practice Address - Street 1:310 CAMINO DE LA PLACITA
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-5951
Practice Address - Country:US
Practice Address - Phone:575-737-6115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine