Organization
SANTA FE DIALECTICAL BEHAVIOR THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JILL M TIEDEMANN LPCC (TEAM LEADER)
(505) 983-8502
Entity
Organization
Contact information
Practice address
411 SAINT MICHAELS DR, SUITE 2, SANTA FE, NM 87505-7655
(505) 983-8502
Mailing address
411 SAINT MICHAELS DR, SUITE 2, SANTA FE, NM 87505-7655
(505) 983-8502
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041S0200X
School Social Worker
—
—
Other
Enumeration date
01/08/2013
Last updated
06/09/2016
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