MEDICARE: CLAIRE SIWULA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	CMF0191751	NM
2	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1316182108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE SIWULA

Provider Business Mailing Address
First Line	:	2116 RIDGEVIEW CIR
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-1101
Country	:	US
Telephone Number	:	505-501-5389
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 CERRILLOS RD STE 201B
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87507-2696
Country	:	US
Telephone Number	:	505-501-5389
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2008
Last Update Date	:	10/27/2021

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Directions to “ CLAIRE SIWULA ” Practice Location

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