Healthcare Provider Details

I. General information

NPI: 1770627192
Provider Name (Legal Business Name): INA KRIEBLE LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 VISTA DEL SUR ST NW
ALBUQUERQUE NM
87120-1546
US

IV. Provider business mailing address

3300 VISTA DEL SUR ST NW
ALBUQUERQUE NM
87120-1546
US

V. Phone/Fax

Practice location:
  • Phone: 505-450-9271
  • Fax: 505-873-8489
Mailing address:
  • Phone: 505-450-9271
  • Fax: 505-873-8489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number006002
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: