Individual
MS. CAROL SUE BRUSCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
5601 DOMINGO RD NE, ALBUQUERQUE, NM 87108
(505) 268-5295
(505) 268-9967
Mailing address
4639 IDLEWILDE LN SE, ALBUQUERQUE, NM 87108-3421
(505) 268-5295
(505) 268-9967
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0097281
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B9311
—
NM
Enumeration date
08/21/2007
Last updated
06/25/2013
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