Healthcare Provider Details

I. General information

NPI: 1770377046
Provider Name (Legal Business Name): MINDFUL HEALING MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3807 ATRISCO DR NW STE A
ALBUQUERQUE NM
87120-4907
US

IV. Provider business mailing address

3807 ATRISCO DR NW STE A
ALBUQUERQUE NM
87120-4907
US

V. Phone/Fax

Practice location:
  • Phone: 505-485-9402
  • Fax:
Mailing address:
  • Phone: 505-485-9402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SANDRA D HOBSON
Title or Position: CEO
Credential: PMHNP
Phone: 505-839-1111