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KALI SUZANNE NAN PETTIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
T-CTL0220451

Contact information

Practice address
119 INDUSTRIAL AVE NE, ALBUQUERQUE, NM 87107-2283
(505) 345-2127
(505) 345-2127
Mailing address
8624 BLUFF SPRINGS DR NE, ALBUQUERQUE, NM 87113-2278
(505) 681-8153
(505) 345-2127

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
T-CTL0220451
NM
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
02/12/2007
Last updated
11/05/2021
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