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General NPI Number Information
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NPI Number | 1386624856
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Entity Type | Individual
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Provider Name | ROSEMARY IMHOF L.P.A.T.
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Gender | Female
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2600 MARBLE NE, 2ND FLOOR
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-0001
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Country | US
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Telephone | 505-272-2872
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Fax |
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Provider Business Mailing Address
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Address Line | 330 MESILLA ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-2041
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Country | US
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Telephone | 505-232-8289
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3254
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License Number State | NM
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