Healthcare Provider Details
I. General information
NPI: 1700690088
Provider Name (Legal Business Name): IN BALANCE BEHAVIORAL & FAMILY THERAPIES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/05/2025
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4233 MONTGOMERY BLVD NE STE J-100
ALBUQUERQUE NM
87109-6749
US
IV. Provider business mailing address
4233 MONTGOMERY BLVD NE STE J-100
ALBUQUERQUE NM
87109-6749
US
V. Phone/Fax
- Phone: 505-523-6313
- Fax: 505-213-3439
- Phone: 505-523-6313
- Fax: 505-213-3439
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MISS
HOLLY
BARRETT
HOPS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: PHD
Phone: 505-523-6313