Healthcare Provider Details
I. General information
NPI: 1770265530
Provider Name (Legal Business Name): MORNINGSTAR INTEGRATIVE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/02/2023
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1502 S SAINT FRANCIS DR
SANTA FE NM
87505-4040
US
IV. Provider business mailing address
1502 S SAINT FRANCIS DR
SANTA FE NM
87505-4040
US
V. Phone/Fax
- Phone: 575-425-0227
- Fax:
- Phone: 575-425-0227
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TARA
E
ZANGHI
Title or Position: LPCC
Credential: LPCC
Phone: 575-425-0227