Diana L Fresquez, MA-LICENSED | |
315 State Ave, Alamosa, CO 81101-2637 | |
(719) 588-8885 | |
Not Available |
Full Name | Diana L Fresquez |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 315 State Ave, Alamosa, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275768277 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 5103 (Colorado) | Primary |
Entity Name | Sondermind Provider Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210113002826 |
Mailing Address | Practice Location Address |
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Diana L Fresquez, MA-LICENSED 315 State Ave, Alamosa, CO 81101-2637 Ph: (719) 588-8885 | Diana L Fresquez, MA-LICENSED 315 State Ave, Alamosa, CO 81101-2637 Ph: (719) 588-8885 |
Raymond Moses Salazar, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2265 Lava Ln, Alamosa, CO 81101 Phone: 719-589-5176 Fax: 719-589-5795 | |
Carol Gurule, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8745 County Road 9 S, Alamosa, CO 81101 Phone: 719-587-5619 | |
Heather Lester, MA LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1123 West Ave, Alamosa, CO 81101 Phone: 719-849-9109 | |
Julie Oliver, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8745 County Road 9 S, Alamosa, CO 81101 Phone: 719-589-3671 Fax: 719-587-5693 | |
Mary Jane Valdez, LPC,CACIII,NCACII Counselor Medicare: Not Enrolled in Medicare Practice Location: 811 Main St, Alamosa, CO 81101 Phone: 719-589-2974 Fax: 719-589-2974 | |
Isaac Martinez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8745 County Road 9 S, Alamosa, CO 81101 Phone: 719-587-5624 Fax: 719-589-9136 | |
Sandra Gutierrez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8745 County Road 9 S, Alamosa, CO 81101 Phone: 719-589-3671 Fax: 719-587-5693 |