Individual
MIRIAM J. CORCORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
201 TULANE DR SE, ALBUQUERQUE, NM 87106-1413
(505) 255-4012
(505) 255-4130
Mailing address
201 TULANE DR SE, ALBUQUERQUE, NM 87106-1413
(505) 255-4012
(505) 255-4130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
478
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201002026
PRESBYTERIAN NUMBER
NM
01
—
850449616
UNITED HEALTH CARE
NM
05
—
N7126
—
NM
01
—
NM00NE75
BLUE CROSS NUMBER
NM
Enumeration date
08/18/2006
Last updated
07/09/2007
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