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NPI 1790641546

NPI 1790641546 : ABBY AUSTIN : SANTA FE, NM

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General NPI Number Information
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    NPI Number           |    1790641546
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    Entity Type          |    Individual 
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    Provider Name        |    ABBY AUSTIN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/24/2025
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    Last Update Date     |    12/24/2025
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Provider Practice Location Address
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    Address Line         |    2209 MIGUEL CHAVEZ RD 
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    City                 |    SANTA FE
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    State                |    NM
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    Zip                  |    87505-6914
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    Country              |    US
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    Telephone            |    505-388-2361
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    677 FAUST RD UNIT 11 
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    City                 |    BURLINGTON
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    State                |    WI
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    Zip                  |    53105-5628
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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        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    CTB-2025-0930
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    License Number State |    NM
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