Healthcare Provider Details

I. General information

NPI: 1992380257
Provider Name (Legal Business Name): DANNER FAMILY THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2021
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 CAMINO DE MONTE REY STE A6
SANTA FE NM
87505-3961
US

IV. Provider business mailing address

223 N GUADALUPE ST # 119
SANTA FE NM
87501-1868
US

V. Phone/Fax

Practice location:
  • Phone: 505-699-3156
  • Fax: 505-554-3435
Mailing address:
  • Phone: 505-699-3156
  • Fax: 505-554-3435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MARI-ANNE CHANEY
Title or Position: BUSINESS MANAGER
Credential:
Phone: 505-315-3128