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General NPI Number Information
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NPI Number | 1659126985
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Entity Type | Individual
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Provider Name | ASTRIA ALEXANDRIA RAYMOS LSAA
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Gender | Female
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Dates
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Enumeration Date | 04/19/2024
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 1227 N RAILROAD AVE STE C
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City | ESPANOLA
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State | NM
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Zip | 87532-3159
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Country | US
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Telephone | 825-747-8259
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Fax | 505-747-8306
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Provider Business Mailing Address
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Address Line | 4601 CARLISLE BLVD NE APT J6
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1060
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Country | US
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Telephone | 505-274-0707
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Fax | 505-274-0707
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CTB-2024-0271
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License Number State | NM
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