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General NPI Number Information
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NPI Number | 1447226030
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Entity Type | Individual
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Provider Name | ANTOINETTE SANDOVAL-CARPENTER LPCC
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Gender | Female
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 1717 GROS VENTRE DR NE
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City | RIO RANCHO
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State | NM
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Zip | 87144-7783
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Country | US
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Telephone | 505-350-6643
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Fax |
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Provider Business Mailing Address
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Address Line | 12 UNSER BLVD SE
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City | RIO RANCHO
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State | NM
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Zip | 87124-6300
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Country | US
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Telephone | 505-896-2520
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0080401
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License Number State | NM
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