Healthcare Provider Details

I. General information

NPI: 1356014419
Provider Name (Legal Business Name): MRS. GEMMA MARY MAJEWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 08/18/2024
Certification Date: 08/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MEDICAL ARTS AVE NE BLDG 3
ALBUQUERQUE NM
87102-2706
US

IV. Provider business mailing address

13009 BEAR DANCER TRL NE
ALBUQUERQUE NM
87112-3726
US

V. Phone/Fax

Practice location:
  • Phone: 505-933-4639
  • Fax:
Mailing address:
  • Phone: 989-493-6907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2022-0952
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: