| Tahlia Rainbolt, Phd, Llc | |
|
460 Saint Michaels Dr Suite 505 Santa Fe NM 87505-7619 | |
| (505) 989-3340 | |
| Not Available |
| Full Name | Tahlia Rainbolt, Phd, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 460 Saint Michaels Dr, Santa Fe, New Mexico |
| Authorized Official Name and Position | Tahlia Rainbolt (OWNER) |
| Authorized Official Contact | 5059893340 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tahlia Rainbolt, Phd, Llc 460 Saint Michaels Dr Suite 505 Santa Fe NM 87505-7619 Ph: () - | Tahlia Rainbolt, Phd, Llc 460 Saint Michaels Dr Suite 505 Santa Fe NM 87505-7619 Ph: (505) 989-3340 |
| NPI Number | 1023413788 |
|---|---|
| Provider Enumeration Date | 10/23/2014 |
| Last Update Date | 10/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023413788 | NPI | - | NPPES |
| 37686232 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1308 (New Mexico) | Primary |
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