Healthcare Provider Details

I. General information

NPI: 1932866258
Provider Name (Legal Business Name): GALEN R SANCHEZ, MA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 BROTHER ABDON WAY
SANTA FE NM
87505-6927
US

IV. Provider business mailing address

2324 BROTHER ABDON WAY
SANTA FE NM
87505-6927
US

V. Phone/Fax

Practice location:
  • Phone: 505-470-6403
  • Fax:
Mailing address:
  • Phone: 505-470-6403
  • 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: MR. GALEN R SANCHEZ
Title or Position: THERAPIST
Credential: PSYCHOTHERAPIST
Phone: 505-470-6403