Healthcare Provider Details

I. General information

NPI: 1760677553
Provider Name (Legal Business Name): CELESTE FRANK PHD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 09/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3044 OLE CT NE
ALBUQUERQUE NM
87111-5624
US

IV. Provider business mailing address

3044 OLE CT NE
ALBUQUERQUE NM
87111-5624
US

V. Phone/Fax

Practice location:
  • Phone: 505-323-6985
  • Fax: 505-291-8493
Mailing address:
  • Phone: 505-323-6985
  • Fax: 505-291-8493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number696
License Number StateNM

VIII. Authorized Official

Name: DR. CELESTE FRANK
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 505-323-6985