| Open Access Video Counseling Llc | |
|
2074 Galisteo St Ste B4 Santa Fe NM 87505-2157 | |
| (505) 301-3408 | |
| (866) 593-5859 |
| Full Name | Open Access Video Counseling Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2074 Galisteo St Ste B4, Santa Fe, New Mexico |
| Authorized Official Name and Position | Rosalie Deryan (CO-OWNER) |
| Authorized Official Contact | 5053013408 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Access Video Counseling Llc 3005 S Saint Francis Dr Ste 1d Santa Fe NM 87505-7004 Ph: (505) 301-3408 | Open Access Video Counseling Llc 2074 Galisteo St Ste B4 Santa Fe NM 87505-2157 Ph: (505) 301-3408 |
| NPI Number | 1861163271 |
|---|---|
| Provider Enumeration Date | 09/24/2021 |
| Last Update Date | 09/24/2021 |
| Certification Date | 09/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861163271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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