MEDICARE: RATIONAL LIFESTYLE CONSULTING LLC

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	101YP2500X	Professional Counselor	0132951	NM

General Provider Information

NPI Number	:	1952851271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RATIONAL LIFESTYLE CONSULTING LLC

Provider Business Mailing Address
First Line	:	310 S LEA AVE
Second Line	:
City	:	ROSWELL
State	:	NM
Zip	:	88203-4562
Country	:	US
Telephone Number	:	505-269-4155
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 S LEA AVE
Second Line	:
City	:	ROSWELL
State	:	NM
Zip	:	88203-4562
Country	:	US
Telephone Number	:	505-269-4155
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. RHONDA R GUTIERREZ
Credential	:	LPCC
Telephone Number	:	505-269-4155

Provider Enumeration Date	:	10/11/2016
Last Update Date	:	10/11/2016

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