Healthcare Provider Details

I. General information

NPI: 1932511433
Provider Name (Legal Business Name): SANDRA LOUISE ENGLISH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2014
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8224 LOUISIANA BLVD NE STE D
ALBUQUERQUE NM
87113-2108
US

IV. Provider business mailing address

5901 WYOMING BLVD NE STE J
ALBUQUERQUE NM
87109-3873
US

V. Phone/Fax

Practice location:
  • Phone: 505-362-4732
  • Fax:
Mailing address:
  • Phone: 505-362-4732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0128071
License Number StateNM

VIII. Authorized Official

Name: MS. SANDRA L ENGLISH
Title or Position: OWNER
Credential: LPCC
Phone: 505-362-4732