Healthcare Provider Details

I. General information

NPI: 1073330916
Provider Name (Legal Business Name): AUTHENTIC HEALING SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/23/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 SOOTHING MEADOWS DRIVE NE
RIO RANCHO NM
87144
US

IV. Provider business mailing address

1380 RIO RANCHO BLVD SE # 453
RIO RANCHO NM
87124-1006
US

V. Phone/Fax

Practice location:
  • Phone: 505-226-2740
  • Fax:
Mailing address:
  • Phone: 505-226-2740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: KARI HERNANDEZ VALDEZ
Title or Position: OWNER
Credential: LPCC
Phone: 505-226-2740