Healthcare Provider Details

I. General information

NPI: 1588226476
Provider Name (Legal Business Name): PAZ COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 07/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3532 ANDERSON AVE SE
ALBUQUERQUE NM
87106-1612
US

IV. Provider business mailing address

2831 MOYA RD NW
ALBUQUERQUE NM
87104-2816
US

V. Phone/Fax

Practice location:
  • Phone: 505-850-6050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: IRINI GEORGAS
Title or Position: OWNER
Credential:
Phone: 505-850-6050