Organization
THNM SKYLINE THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RUTH DISMUKE-BLAKELY MS CCC SLP (OWNER)
(505) 281-1811
Entity
Organization
Contact information
Practice address
1090 MOUNTAIN VALLEY RD, EDGEWOOD, NM 87015
(505) 281-1811
(505) 281-7704
Mailing address
PO BOX 2225, EDGEWOOD, NM 87015-2225
(505) 281-1811
(505) 281-7704
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10025412
LOVELACE HEALTH PLAN
NM
Enumeration date
12/19/2006
Last updated
09/11/2025
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