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General NPI Number Information
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NPI Number | 1174283493
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Entity Type | Organization
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Legal Business Name | TODO CAMBIA LLC
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Dates
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Enumeration Date | 12/28/2021
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 1127 12TH ST NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87104-2166
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Country | US
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Telephone | 505-720-3342
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7906
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City | ALBUQUERQUE
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State | NM
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Zip | 87194-7906
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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 | LUCIA DARLACH
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Credential |
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Telephone | 505-720-3342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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