Healthcare Provider Details

I. General information

NPI: 1265208946
Provider Name (Legal Business Name): ASHLEY SETZER THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2356 FOX RD STE 300
SANTA FE NM
87507-7294
US

IV. Provider business mailing address

131 RIDGECREST DR
SANTA FE NM
87505-6334
US

V. Phone/Fax

Practice location:
  • Phone: 716-946-6377
  • Fax:
Mailing address:
  • Phone: 716-946-6377
  • 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: ASHLEY SETZER
Title or Position: OWNER
Credential:
Phone: 716-946-6377