Organization
BLUE PHOENIX THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA M BARELA (OWNER)
(505) 219-1028
Entity
Organization
Contact information
Practice address
1740 GRANDE BLVD SE STE D-4, RIO RANCHO, NM 87124-1799
(505) 219-1028
Mailing address
1740 GRANDE BLVD SE STE D-4, RIO RANCHO, NM 87124-1799
(505) 219-1028
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01354353
—
NM
Enumeration date
03/25/2022
Last updated
08/29/2024
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