Individual
MS. TISH TENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4216 BALLOON PARK RD NE, ALBUQUERQUE, NM 87109-5801
(505) 344-5470
(505) 344-9343
Mailing address
7639 CALLE COMODO NE, ALBUQUERQUE, NM 87113-2365
(505) 203-2495
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1914
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1914
OCCUPATIONAL THERAPY ASST
NM
Enumeration date
02/06/2007
Last updated
07/08/2007
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