Organization
BODHI THERAPEUTIC SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILLE PARSONS (CFO)
(505) 907-7436
Entity
Organization
Contact information
Practice address
709 CENTRAL AVE NW, ALBUQUERQUE, NM 87102-3007
(505) 907-7436
Mailing address
709 CENTRAL AVE NW, ALBUQUERQUE, NM 87102-3007
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
07/15/2018
Last updated
07/15/2018
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