| Amy Brashear Llc | |
|
12805 Menaul Blvd Ne Albuquerque NM 87112-2547 | |
| (505) 850-9419 | |
| Not Available |
| Full Name | Amy Brashear Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12805 Menaul Blvd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Amy Terrell Brashear (OWNER) |
| Authorized Official Contact | 5058509419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Brashear Llc 12404 Tularosa Trl Ne Albuquerque NM 87111-7275 Ph: (505) 850-9419 | Amy Brashear Llc 12805 Menaul Blvd Ne Albuquerque NM 87112-2547 Ph: (505) 850-9419 |
| NPI Number | 1063767945 |
|---|---|
| Provider Enumeration Date | 07/17/2012 |
| Last Update Date | 07/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063767945 | NPI | - | NPPES |
| 19973748 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0095411 (New Mexico) | Primary |
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