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General NPI Number Information
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NPI Number | 1184983900
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Entity Type | Organization
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Legal Business Name | CONEXIONES COUNSELING AND CONSULTING, LLC.
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Dates
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Enumeration Date | 05/14/2012
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Last Update Date | 05/14/2012
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Provider Practice Location Address
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Address Line | 5820 4TH ST NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-5368
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Country | US
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Telephone | 505-883-2951
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Fax |
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Provider Business Mailing Address
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Address Line | 416 EL DORADO DR NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-1709
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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 | DIRECTOR
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Name | DR. VIVIAN A. FERNANDEZ GEILIN
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Credential | PH.D.
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Telephone | 505-883-2951
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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 | 1290
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License Number State | NM
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