MEDICARE: DIANA STEARNS LMFT

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	0160971	NM
2	106H00000X	Marriage & Family Therapist	CMF0201151	NM

General Provider Information

NPI Number	:	1528234994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA STEARNS LMFT

Provider Business Mailing Address
First Line	:	2601 WYOMING BLVD NE STE 202
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87112-1033
Country	:	US
Telephone Number	:	505-238-4143
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 WYOMING BLVD NE STE 202
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87112-1033
Country	:	US
Telephone Number	:	505-238-4143
Fax Number	:

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

Provider Enumeration Date	:	05/05/2008
Last Update Date	:	04/17/2019

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Directions to “ DIANA STEARNS LMFT” Practice Location

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