Healthcare Provider Details

I. General information

NPI: 1356221865
Provider Name (Legal Business Name): SHES KNOWN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

861 VIA GLORIETA
SUNLAND PARK NM
88063-9629
US

IV. Provider business mailing address

861 VIA GLORIETA
SUNLAND PARK NM
88063-9629
US

V. Phone/Fax

Practice location:
  • Phone: 915-344-1885
  • Fax:
Mailing address:
  • Phone: 915-344-1885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: GRACE ANGELES
Title or Position: CEO
Credential: LPCC
Phone: 915-549-2097