Healthcare Provider Details

I. General information

NPI: 1417504168
Provider Name (Legal Business Name): BEAUTIFUL TRANSITIONS CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2019
Last Update Date: 08/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9404 CASITAS CT SW
ALBUQUERQUE NM
87121-9482
US

IV. Provider business mailing address

9404 CASITAS CT SW
ALBUQUERQUE NM
87121-9482
US

V. Phone/Fax

Practice location:
  • Phone: 505-322-9850
  • Fax:
Mailing address:
  • Phone: 505-322-9850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: STACY BURLESON
Title or Position: MENTAL HEALTH FIRST AID INSTRUCTOR
Credential: MHFA INSTRUCTOR
Phone: 505-322-9850