Organization
505 DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBEKAH JAN HUTCHINS KHAN (CEO/PROVIDER)
(470) 728-9352
Entity
Organization
Contact information
Practice address
4225 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1103
(505) 361-1931
(505) 521-5147
Mailing address
4225 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1103
(505) 548-8035
(505) 581-3291
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
06/11/2024
Last updated
02/04/2025
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