Healthcare Provider Details

I. General information

NPI: 1962887737
Provider Name (Legal Business Name): DORCAS F BREM COUNSELING SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 MARR ST
TRUTH OR CONSEQUENCES NM
87901-3381
US

IV. Provider business mailing address

428 MARR ST
TRUTH OR CONSEQUENCES NM
87901-3381
US

V. Phone/Fax

Practice location:
  • Phone: 575-937-7751
  • Fax:
Mailing address:
  • Phone: 575-937-7751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0109611
License Number StateNM

VIII. Authorized Official

Name: MS. DORCAS FIELDSON BREM
Title or Position: OWNER
Credential: LPCC
Phone: 575-937-7751