| |
4 San Francisco St Unit 1424 Ranchos De Taos NM 87557-4057 | |
(469) 855-9107 | |
(469) 533-5979 |
Full Name | |
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Speciality | Counselor - Professional |
Location | 4 San Francisco St Unit 1424, Ranchos De Taos, New Mexico |
Authorized Official Name and Position | Don Zablosky (OWNER) |
Authorized Official Contact | 4698559107 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1424 Ranchos De Taos NM 87557-1424 Ph: (469) 855-9107 | 4 San Francisco St Unit 1424 Ranchos De Taos NM 87557-4057 Ph: (469) 855-9107 |
NPI Number | 1477251817 |
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Provider Enumeration Date | 02/15/2023 |
Last Update Date | 01/06/2025 |
Certification Date | 01/06/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477251817 | NPI | - | NPPES |
1618415-03 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
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