Healthcare Provider Details

I. General information

NPI: 1326753559
Provider Name (Legal Business Name): MARLOWE ROSEMAE POHL LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 SAN PEDRO DR NE STE A
ALBUQUERQUE NM
87110-9812
US

IV. Provider business mailing address

1610 SAN PEDRO DR NE STE A
ALBUQUERQUE NM
87110-9812
US

V. Phone/Fax

Practice location:
  • Phone: 505-265-0753
  • Fax:
Mailing address:
  • Phone: 505-265-0753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2023-0040
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: