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General NPI Number Information
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NPI Number | 1396334272
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Entity Type | Individual
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Provider Name | LAURA HILFERTY
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Gender | Female
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Dates
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Enumeration Date | 01/14/2021
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 313 12TH ST SW
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-2876
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Country | US
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Telephone | 732-439-3919
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 MEDICAL ARTS AVE NE BLDG 3
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-2722
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Country | US
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Telephone | 732-439-3919
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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 | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 23-436
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CMH0224321
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License Number State | NM
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