Healthcare Provider Details

I. General information

NPI: 1922710367
Provider Name (Legal Business Name): ARTESANA COUNSELING AND ART THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2022
Last Update Date: 12/16/2022
Certification Date: 12/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 CENTER DR STE 2
SANTA FE NM
87507-9745
US

IV. Provider business mailing address

1629 STATE ROAD 502
SANTA FE NM
87506-2691
US

V. Phone/Fax

Practice location:
  • Phone: 505-819-9966
  • Fax:
Mailing address:
  • Phone: 505-819-9966
  • 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: ISABEL RIBE
Title or Position: OWNER
Credential:
Phone: 505-819-9966