Organization
ASPEN VISTA THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAUREL M SHAFTER LCSW (OWNER/OPERATOR)
(505) 577-7866
Entity
Organization
Contact information
Practice address
1691 GALISTEO ST STE D, SANTA FE, NM 87505-4781
(505) 954-1921
(505) 983-6520
Mailing address
1691 GALISTEO ST STE D, SANTA FE, NM 87505-4781
(505) 954-1921
(505) 983-6520
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
17-00146320
NM
Other
Enumeration date
08/18/2017
Last updated
09/10/2019
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