Healthcare Provider Details

I. General information

NPI: 1023855145
Provider Name (Legal Business Name): EMMA SNUGGERUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 MENAUL BLVD NE STE B460
ALBUQUERQUE NM
87112-2250
US

IV. Provider business mailing address

55 CATHEDRAL ROCK DR UNIT 15
SEDONA AZ
86351-8633
US

V. Phone/Fax

Practice location:
  • Phone: 505-974-0104
  • Fax:
Mailing address:
  • Phone: 505-974-1517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: