| Sandia Autism Services Llc | |
|
9123 Palomas Ave Ne Albuquerque NM 87109-6632 | |
| (505) 274-9018 | |
| Not Available |
| Full Name | Sandia Autism Services Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 9123 Palomas Ave Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Kyle I Wortman (OWNER) |
| Authorized Official Contact | 5052749018 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandia Autism Services Llc 9123 Palomas Ave Ne Albuquerque NM 87109-6632 Ph: (505) 274-9018 | Sandia Autism Services Llc 9123 Palomas Ave Ne Albuquerque NM 87109-6632 Ph: (505) 274-9018 |
| NPI Number | 1174298319 |
|---|---|
| Provider Enumeration Date | 08/10/2021 |
| Last Update Date | 08/10/2021 |
| Certification Date | 08/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174298319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106E00000X | Assistant Behavior Analyst | (* (Not Available)) | Secondary |
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