Healthcare Provider Details

I. General information

NPI: 1598494056
Provider Name (Legal Business Name): ILEANA SAENZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 S TELSHOR BLVD STE Q102
LAS CRUCES NM
88011-4681
US

IV. Provider business mailing address

425 MARQUEZ ST
ANTHONY NM
88021-8101
US

V. Phone/Fax

Practice location:
  • Phone: 575-888-4666
  • Fax:
Mailing address:
  • Phone: 915-777-5216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: