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Individual

MS. DANIELLA BRANTLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
(888) 663-2759
Mailing address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
(888) 663-2759

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CMH0211511
NM
171M00000X
Case Manager/Care Coordinator
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1376168310
NM
Enumeration date
06/16/2020
Last updated
02/04/2022
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