Organization
SOULCARE INTEGRATIVE PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA DINENNO PMHNP-BC (PSYCHIATRIC NURSE PRACTITIONER)
(505) 918-2501
Entity
Organization
Contact information
Practice address
12 MAIN ST UNIT 1239, LA LUZ, NM 88337-1651
(505) 918-2501
Mailing address
12 MAIN ST UNIT 1239, LA LUZ, NM 88337-1651
(575) 201-9860
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/24/2025
Last updated
03/18/2025
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