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General NPI Number Information
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NPI Number | 1841972965
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Entity Type | Organization
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Legal Business Name | PANORAMA HEALING LLC
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 500 MARQUETTE AVE NW STE 1241
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-5340
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Country | US
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Telephone | 505-313-2941
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Fax |
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Provider Business Mailing Address
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Address Line | 6831 CALLE CIELO SW
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City | ALBUQUERQUE
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State | NM
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Zip | 87121-4345
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Country | US
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Telephone | 505-313-2941
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | ANA ROSA COBOS
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Credential | LCSW
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Telephone | 505-313-2941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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