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General NPI Number Information
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NPI Number | 1780941500
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Entity Type | Individual
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Provider Name | STEPHANIE MICHELLE ALBURY M.A.
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Gender | Female
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 04/25/2012
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Provider Practice Location Address
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Address Line | 1919 5TH ST SUITE B
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City | SANTA FE
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State | NM
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Zip | 87505-5402
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Country | US
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Telephone | 505-409-1271
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 5TH ST SUITE B
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City | SANTA FE
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State | NM
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Zip | 87505-5402
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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 |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | T-0149091
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License Number State | NM
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