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General NPI Number Information
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NPI Number | 1073172854
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Entity Type | Organization
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Legal Business Name | KATHERINE BASSIRI, LLC.
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 5300 SEQUOIA RD NW STE 207
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1248
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Country | US
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Telephone | 505-750-3233
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Fax |
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Provider Business Mailing Address
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Address Line | 9528 VALLETTA AVE NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-2996
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE BASSIRI
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Credential | LPCC
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Telephone | 505-750-3233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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