Healthcare Provider Details

I. General information

NPI: 1164174538
Provider Name (Legal Business Name): GABRIELA LUCIA RAMIREZ-VALLES LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GABRIELA L RAMIREZ

II. Dates (important events)

Enumeration Date: 01/26/2022
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6612 GULTON CT NE
ALBUQUERQUE NM
87109-4407
US

IV. Provider business mailing address

9251 EAGLE RANCH RD NW APT 1522
ALBUQUERQUE NM
87114-6057
US

V. Phone/Fax

Practice location:
  • Phone: 505-888-1686
  • Fax: 505-888-1683
Mailing address:
  • Phone: 575-637-2426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0219731
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: