Organization
INTEGRATIVE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN BURNS LMFT (PROPRIETOR)
(505) 795-8190
Entity
Organization
Contact information
Practice address
128 GRANT AVE, STE 218, SANTA FE, NM 87501-2031
(505) 795-8190
Mailing address
209 VUELTA ROBLE, SANTA FE, NM 87501-1625
(505) 795-8190
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0103251
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80473024
—
NM
Enumeration date
11/18/2009
Last updated
12/07/2009
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