Healthcare Provider Details

I. General information

NPI: 1932360393
Provider Name (Legal Business Name): BONNIE FRIEDMAN SANCHEZ MA LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8220 LA MIRADA PL NE #200
ALBUQUERQUE NM
87109-1657
US

IV. Provider business mailing address

8220 LA MIRADA PL NE #200
ALBUQUERQUE NM
87109-1657
US

V. Phone/Fax

Practice location:
  • Phone: 505-292-4470
  • Fax:
Mailing address:
  • Phone: 505-292-4470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberO555
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: