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General NPI Number Information
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NPI Number | 1972671212
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Entity Type | Organization
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Legal Business Name | A NEW DAY
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 1330 SAN PEDRO NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110
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Country | US
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Telephone | 505-260-9912
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Fax |
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Provider Business Mailing Address
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Address Line | 1320 DESERT RIDGE RD SE
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City | RIO RANCHO
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State | NM
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Zip | 87124-1445
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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 | CLINICAL COUNSELOR
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Name | DR. JEANNETTE V OTERO
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Credential | ED.D.
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Telephone | 505-260-9912
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 005631
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License Number State | NM
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