Individual
MS. KARLA A TREVIZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMHC
Contact information
Practice address
707 BROADWAY BLVD NE STE 103, ALBUQUERQUE, NM 87102-2300
(505) 933-4639
Mailing address
707 BROADWAY BLVD NE STE 103, ALBUQUERQUE, NM 87102-2300
(505) 933-4639
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CMH0195671
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952699654
—
NM
Enumeration date
10/10/2018
Last updated
10/10/2018
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