Provider Demographics
NPI:1679118707
Name:TAL THERAPIES LLC
Entity type:Organization
Organization Name:TAL THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LIFVERGREN
Authorized Official - Suffix:
Authorized Official - Credentials:OTL/R
Authorized Official - Phone:575-770-5360
Mailing Address - Street 1:238 AMBROSIO ST APT 1
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-2868
Mailing Address - Country:US
Mailing Address - Phone:575-770-5836
Mailing Address - Fax:505-982-0732
Practice Address - Street 1:150 S SAINT FRANCIS DR
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-2445
Practice Address - Country:US
Practice Address - Phone:575-770-5836
Practice Address - Fax:505-982-0732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty