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General NPI Number Information
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NPI Number | 1457043184
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Entity Type | Organization
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Legal Business Name | ATHENA MENTAL HEALTH
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 4091 SOTOL DR
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City | LAS CRUCES
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State | NM
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Zip | 88011-7640
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Country | US
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Telephone | 575-323-1603
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Fax |
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Provider Business Mailing Address
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Address Line | 141 N ROADRUNNER PKWY STE 141
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City | LAS CRUCES
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State | NM
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Zip | 88011-2000
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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 | CONSULTANT
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Name | SHELBY WASHINGTON
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Credential |
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Telephone | 678-383-0907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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