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General NPI Number Information
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NPI Number | 1609368976
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Entity Type | Individual
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Provider Name | AVERY LEIGH BARNARD
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Gender | Female
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Dates
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Enumeration Date | 06/03/2018
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 6330 RIVERSIDE PLAZA LN NW STE 260
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-2160
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Country | US
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Telephone | 505-226-2839
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Fax | 505-295-2559
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Provider Business Mailing Address
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Address Line | 524 MISSION AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-4906
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Country | US
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Telephone | 505-440-9501
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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 | CTB20240817
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License Number State | NM
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