Organization
OUR IMAGINAL WORLD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGDALENA KARLICK ATR-BC, LPCC (DIRECTOR)
(917) 626-5360
Entity
Organization
Contact information
Practice address
245 ROSARIO BLVD APT C, SANTA FE, NM 87501-1373
(917) 626-5360
Mailing address
245 ROSARIO BLVD APT C, SANTA FE, NM 87501-1373
(917) 626-5360
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326276288
—
NM
Enumeration date
04/08/2022
Last updated
04/08/2022
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