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General NPI Number Information
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NPI Number | 1730994724
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Entity Type | Individual
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Provider Name | ANGELA HERRERA KOREN
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Gender | Female
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Dates
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Enumeration Date | 02/08/2025
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Last Update Date | 02/08/2025
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Provider Practice Location Address
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Address Line | 6200 SEAGULL ST NE STE B
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-2547
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Country | US
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Telephone | 505-537-9725
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Fax |
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Provider Business Mailing Address
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Address Line | 5300 ANTEQUERA RD NW APT 2205
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-4591
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Country | US
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Telephone | 505-225-9197
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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