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General NPI Number Information
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NPI Number | 1063429157
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Entity Type | Organization
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Legal Business Name | WHITEOWL SERVICES, INC.
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3300 VISTA DEL SUR ST NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1546
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Country | US
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Telephone | 505-450-9271
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Fax | 505-873-8489
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Provider Business Mailing Address
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Address Line | 3300 VISTA DEL SUR ST NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1546
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Country | US
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Telephone | 505-450-9271
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Fax | 505-873-8489
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Authorized Official
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Title or Position | PRESIDENT
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Name | INA KRIEBLE
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Credential |
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Telephone | 505-450-9271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 006002
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License Number State | NM
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