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Organization

NEURODIVERSE OT, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SARAH MARRICH MSOT, OTR/L (OWNER)
(505) 239-4097
Entity
Organization

Contact information

Practice address
12121 RANCHITOS RD NE, ALBUQUERQUE, NM 87122-2320
(505) 239-4097
Mailing address
12121 RANCHITOS RD NE, ALBUQUERQUE, NM 87122-2320
(505) 239-4097

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1326597634
CA
Enumeration date
10/06/2020
Last updated
10/06/2020
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