Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003290842 |
---|---|
Provider Name | Suzanne Salladin |
First Address | Albuquerque, NM 87120-1213 |
Second Address | Santa Fe, NM 87507-4851 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2015 |
Last Update Date | 10/07/2015 |