Organization
ZIA BEHAVIORAL HEALTH, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON W FREEDLE (MANAGING PARTNER)
(505) 820-0262
Entity
Organization
Contact information
Practice address
2504 CAMINO ENTRADA, SANTA FE, NM 87507-4851
(505) 820-0262
(505) 820-9220
Mailing address
PO BOX 28220, SANTA FE, NM 87592-8220
(505) 820-0262
(505) 820-9220
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
06-03806
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28178751
—
NM
Enumeration date
08/31/2006
Last updated
05/05/2009
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