Tahlia Rainbolt, Ph.D.
Psychologist, Clinical in Santa Fe, NM. Individual provider (NPI-1).
NPI number1861892465
StatusActive
Last updated in NPPESJul 30, 2020
Details
- NPI
- 1861892465
- Entity type
- Individual (NPI-1)
- Name
- Tahlia Rainbolt
- Credential
- Ph.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 2, 2014
- Certification date
- Jul 30, 2020
- Last updated
- Jul 30, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 1308 | NM | Yes |
Practice location
1012 Marquez Pl # 211Santa Fe, NM 87505-1834
Phone 505-989-3340
Mailing address
1012 Marquez Pl # 211Santa Fe, NM 87505-1834
Phone 505-989-3340
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