Healthcare Provider Details

I. General information

NPI: 1063670081
Provider Name (Legal Business Name): MARNIE I SADEK MA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2741 INDIAN SCHOOL RD NE
ALBUQUERQUE NM
87106
US

IV. Provider business mailing address

7100 WAY CROSS AVE NW
ALBUQUERQUE NM
87120
US

V. Phone/Fax

Practice location:
  • Phone: 505-710-9299
  • Fax: 505-255-7890
Mailing address:
  • Phone: 505-710-9299
  • Fax: 505-255-7890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0106901
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: