Healthcare Provider Details

I. General information

NPI: 1891929204
Provider Name (Legal Business Name): ALANIZ ACUPUNCTURE & THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2009
Last Update Date: 05/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 7TH ST
LAS VEGAS NM
87701-4920
US

IV. Provider business mailing address

1620 7TH ST
LAS VEGAS NM
87701-4920
US

V. Phone/Fax

Practice location:
  • Phone: 505-454-7694
  • Fax: 505-454-0595
Mailing address:
  • Phone: 505-454-7694
  • Fax: 505-454-0595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA L. ALANIZ
Title or Position: OWNER
Credential: LPCC, D.O.M.
Phone: 505-454-7694