| Ernestine Tennefos | |
|
930 W 17th St Portales NM 88130-6635 | |
| (575) 791-5507 | |
| Not Available |
| Full Name | Ernestine Tennefos |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 930 W 17th St, Portales, New Mexico |
| Authorized Official Name and Position | Ernestine Tennefos (MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 5757915507 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ernestine Tennefos 930 W 17th St Portales NM 88130-6635 Ph: (575) 791-5507 | Ernestine Tennefos 930 W 17th St Portales NM 88130-6635 Ph: (575) 791-5507 |
| NPI Number | 1972257855 |
|---|---|
| Provider Enumeration Date | 02/09/2022 |
| Last Update Date | 02/09/2022 |
| Certification Date | 02/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972257855 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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