Healthcare Provider Details

I. General information

NPI: 1407928591
Provider Name (Legal Business Name): VIRGINIA L ALANIZ LPCC DOM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 05/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 7TH STREET
LAS VEGAS NM
87701
US

IV. Provider business mailing address

1620 7TH STREET
LAS VEGAS NM
87701
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number521
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: