Healthcare Provider Details

I. General information

NPI: 1639690308
Provider Name (Legal Business Name): ASHLEY SETZER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 12/05/2023
Certification Date: 12/03/2023
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

2356 FOX RD STE 300
SANTA FE NM
87507-7294
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
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: