Healthcare Provider Details

I. General information

NPI: 1396338562
Provider Name (Legal Business Name): AFA PSYCHOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 10/01/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 AMERICAS PKWY NE STE 200
ALBUQUERQUE NM
87110-8172
US

IV. Provider business mailing address

3705 B-1 ELLISON BLVD #301
ALBUQUERQUE NM
87114
US

V. Phone/Fax

Practice location:
  • Phone: 646-863-5379
  • Fax:
Mailing address:
  • Phone: 646-863-5379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. ANGELICA MARIA FLORES-ARMAN
Title or Position: OWNER
Credential: PH.D.
Phone: 646-863-5379