Healthcare Provider Details

I. General information

NPI: 1003680836
Provider Name (Legal Business Name): A HEALING TOUCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2902 DURANES RD NW
ALBUQUERQUE NM
87104-2785
US

IV. Provider business mailing address

2902 DURANES RD NW
ALBUQUERQUE NM
87104-2785
US

V. Phone/Fax

Practice location:
  • Phone: 505-596-0366
  • Fax:
Mailing address:
  • Phone: 505-596-0366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHANNON NICOLE BALDONADO
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 505-596-0366