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NPI Code Detail

MEDICARE: MS. REBECCA ELISABETH COLLA

MEDICARE: MS. REBECCA ELISABETH COLLA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorC5364OR
2101YM0800XMental Health Counselor0158831NM
3101YM0800XMental Health Counselor7401CA

General Provider Information

NPI Number : 1538493101
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. REBECCA ELISABETH COLLA
Provider Business Mailing Address
First Line : 1031 LAMBERTON PL NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87107-1641
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1031 LAMBERTON PL NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87107-1641
Country : US
Telephone Number : 505-272-2190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2009
Last Update Date : 06/08/2023

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Directions to “ MS. REBECCA ELISABETH COLLA ” Practice Location

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