Individual
MS. ANNA KATHERINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
214 LORENZO LANE, SANTA FE, NM 87501
(505) 988-2583
Mailing address
210 GONZALES ROAD, SANTA FE, NM 87501
(505) 988-2583
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1066
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00R76K
BLUE CROSS BLUE SHIELD
NM
05
—
18679374
—
NM
01
—
NM101653
VALUE OPTIONS
NM
Enumeration date
11/17/2006
Last updated
07/08/2007
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