Healthcare Provider Details

I. General information

NPI: 1528900370
Provider Name (Legal Business Name): CORAZON SOMATICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 CERRO GORDO RD
SANTA FE NM
87501-6175
US

IV. Provider business mailing address

1608 CERRO GORDO RD
SANTA FE NM
87501-6175
US

V. Phone/Fax

Practice location:
  • Phone: 970-903-8281
  • Fax:
Mailing address:
  • Phone: 970-903-8281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: CORA ELIZABETH KILGO
Title or Position: COUNSELOR
Credential: LMFT
Phone: 970-903-8281