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General NPI Number Information
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NPI Number | 1417774951
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Entity Type | Individual
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Provider Name | KYLAN PINKELMAN
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Gender | Female
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Dates
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Enumeration Date | 09/25/2024
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 901 RIO GRANDE BLVD NW STE F252
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City | ALBUQUERQUE
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State | NM
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Zip | 87104-2057
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Country | US
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Telephone | 505-702-8112
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Fax | 505-355-2611
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Provider Business Mailing Address
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Address Line | 901 RIO GRANDE BLVD NW STE F252
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City | ALBUQUERQUE
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State | NM
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Zip | 87104-2057
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Country | US
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Telephone | 505-702-8112
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Fax | 505-355-2611
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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 | CTB-2025-0743
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License Number State | NM
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