Healthcare Provider Details

I. General information

NPI: 1063760973
Provider Name (Legal Business Name): ALAYNA AMBER OROZCO LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2012
Last Update Date: 07/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5203 JUAN TABO BLVD NE SUITE 2B
ALBUQUERQUE NM
87111-2683
US

IV. Provider business mailing address

5203 JUAN TABO BLVD NE SUITE 2B
ALBUQUERQUE NM
87111-2683
US

V. Phone/Fax

Practice location:
  • Phone: 505-417-7261
  • Fax:
Mailing address:
  • Phone: 505-417-7261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0174221
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: