Individual
MS. OLIVIA MELISSA PASTORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
6100 SEAGULL ST NE, ALBUQUERQUE, NM 87109-2500
(855) 728-8476
(855) 728-8476
Mailing address
PO BOX 14572, ALBUQUERQUE, NM 87191-4572
(505) 316-2280
(505) 316-2280
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
247200000X/TECHNITIO
—
NM
Enumeration date
09/02/2009
Last updated
08/31/2020
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