Healthcare Provider Details

I. General information

NPI: 1003923202
Provider Name (Legal Business Name): KAREN KAUFMAN MILSTEIN PHD LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 RANCHO ALEGRE RD
SANTA FE NM
87508
US

IV. Provider business mailing address

162 RANCHO ALEGRE RD
SANTA FE NM
87508
US

V. Phone/Fax

Practice location:
  • Phone: 505-995-9596
  • Fax: 505-474-8014
Mailing address:
  • Phone: 505-995-9596
  • Fax: 505-474-8014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI1510
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: