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General NPI Number Information
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NPI Number | 1912653163
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Entity Type | Organization
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Legal Business Name | LORETTA S OHMAYE
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Dates
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Enumeration Date | 02/25/2022
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 2209 MIGUEL CHAVEZ BLDG. A, STE B
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City | SANTA FE
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State | NM
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Zip | 87505
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Country | US
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Telephone | 505-930-0186
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Fax |
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Provider Business Mailing Address
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Address Line | 4 BRIMHALL WASH
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City | SANTA FE
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State | NM
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Zip | 87508-4817
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Country | US
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Telephone | 505-930-0186
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | LORETTA (LARA) OHMAYE
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Credential | LPCC
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Telephone | 505-930-0186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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