Individual
ABIGAIL GRACE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 RIO GRANDE BLVD NW STE G252, ALBUQUERQUE, NM 87104-2050
(505) 702-8112
Mailing address
10331 DUNBAR ST NW, ALBUQUERQUE, NM 87114-5522
(505) 573-4242
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CTB-2024-0293
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9732654268
HPSO
NM
Enumeration date
11/29/2022
Last updated
03/05/2025
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