Individual
NATALYA BACKHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
12 UNSER BLVE SE, SUITE C, RIO RANCHO, NM 87124-0000
(505) 531-8361
Mailing address
12 UNSER BLVE SE, SUITE C, RIO RANCHO, NM 87124-0000
(505) 531-8361
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CTB-2023-0520
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
CTB-2023-0520
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
97628379
—
NM
Enumeration date
03/07/2023
Last updated
12/31/2024
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