Organization
MAGIC LENS COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN HOOGERBRUGGE LMFT (OWNER)
(505) 715-2802
Entity
Organization
Contact information
Practice address
1124 PARK AVE SW, ALBUQUERQUE, NM 87102-2941
(505) 715-2802
Mailing address
PO BOX 94508, ALBUQUERQUE, NM 87199-4508
(505) 384-7352
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0120991
NM
Other
Enumeration date
04/12/2017
Last updated
04/12/2017
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