Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | T-0143151 | NM |
Y | 101YP2500X | Professional Counselor |
NPI | 1003146234 |
---|---|
Provider Name | Mrs. Rachel Offineer Roberts |
First Address | Albuquerque, NM 87114 |
Second Address | Albuquerque, NM 87114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2010 |
Last Update Date | 05/11/2013 |