Healthcare Provider Details

I. General information

NPI: 1760481543
Provider Name (Legal Business Name): CHRISTOPHER PATRICK SANGER I L.P.C.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 ENCINO PL NE SUITE C-14
ALBUQUERQUE NM
87102-2612
US

IV. Provider business mailing address

8205 WILLIAM MOYERS AVE NE
ALBUQUERQUE NM
87122-2730
US

V. Phone/Fax

Practice location:
  • Phone: 505-453-2683
  • Fax:
Mailing address:
  • Phone: 505-453-2683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0512
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: