Individual
MRS. LORA BLAZINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, MHSP
Contact information
Practice address
12760 SAN RAFAEL AVE NE, ALBUQUERQUE, NM 87122-1133
(505) 382-9742
Mailing address
PO BOX 1602, TIJERAS, NM 87059-1602
(505) 382-9742
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3074
TN
Other
Enumeration date
11/26/2013
Last updated
12/18/2024
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