Healthcare Provider Details

I. General information

NPI: 1467613604
Provider Name (Legal Business Name): NATALIE M NARANJO-RODRIGUEZ MA LPC NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CAMINO VEGA VERDE
CORRALES NM
87048
US

IV. Provider business mailing address

20 CAMINO VEGA VERDE
CORRALES NM
87048-8529
US

V. Phone/Fax

Practice location:
  • Phone: 505-260-9912
  • Fax: 505-260-9934
Mailing address:
  • Phone: 505-450-9526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0059101
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: