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General NPI Number Information
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NPI Number | 1093262636
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Entity Type | Organization
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Legal Business Name | PLATICAS
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 1820 SAN PEDRO NE SUITE 9
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-5956
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Country | US
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Telephone | 505-710-2291
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Fax | 505-872-0050
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Provider Business Mailing Address
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Address Line | P O BOX 8085
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City | ALBUQUERQUE
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State | NM
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Zip | 87198-8085
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Country | US
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Telephone | 505-710-2291
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Fax | 505-872-0050
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Authorized Official
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Title or Position | OWNER
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Name | BLANCA ELIA
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Credential | MA,NCC,LPCC
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Telephone | 505-710-2291
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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 | 0160661
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License Number State | NM
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