Individual
AMBER K MACIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, DS II
Contact information
Practice address
1111 MENAUL BLVD NE, ALBUQUERQUE, NM 87107-1614
(505) 459-5899
Mailing address
1111 MENAUL BLVD NE, ALBUQUERQUE, NM 87107-1614
(505) 459-5899
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
251S00000X
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172V00000X
—
NM
Enumeration date
03/24/2010
Last updated
03/24/2010
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