Healthcare Provider Details

I. General information

NPI: 1982938387
Provider Name (Legal Business Name): JOAN EILEEN SANCHEZ DS1
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 10/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 LOPEZ RD SW
ALBUQUERQUE NM
87105-3954
US

IV. Provider business mailing address

1101 LOPEZ RD SW
ALBUQUERQUE NM
87105-3954
US

V. Phone/Fax

Practice location:
  • Phone: 505-877-7060
  • Fax: 505-877-7063
Mailing address:
  • Phone: 505-877-7060
  • Fax: 505-877-7063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: