Healthcare Provider Details

I. General information

NPI: 1518530583
Provider Name (Legal Business Name): ANGEL SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 GOLF COURSE RD SE
RIO RANCHO NM
87124-1999
US

IV. Provider business mailing address

5350 JUSTIN DR NW APT 27
ALBUQUERQUE NM
87114-4420
US

V. Phone/Fax

Practice location:
  • Phone: 505-994-4100
  • Fax:
Mailing address:
  • Phone: 505-227-5772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: