| Cottonwood Therapy Associate | |
|
190 Central Park Sq Suite 105 Los Alamos NM 87544-4001 | |
| (505) 662-1419 | |
| (505) 672-1739 |
| Full Name | Cottonwood Therapy Associate |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 190 Central Park Sq, Los Alamos, New Mexico |
| Authorized Official Name and Position | Donna Marie Giaquinto (DIRECTOR) |
| Authorized Official Contact | 5056621419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cottonwood Therapy Associate 190 Central Park Sq Suite 105 Los Alamos NM 87544-4001 Ph: (505) 662-1419 | Cottonwood Therapy Associate 190 Central Park Sq Suite 105 Los Alamos NM 87544-4001 Ph: (505) 662-1419 |
| NPI Number | 1104803675 |
|---|---|
| Provider Enumeration Date | 12/27/2005 |
| Last Update Date | 03/25/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104803675 | NPI | - | NPPES |
| 000B9545 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 200110082 (New Mexico) | Primary |
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