Organization
STAR MOUNTAIN THERAPY, LLC
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEATHER MARIE RUBENS LCSW, MPH (LCSW/ THERAPIST)
(213) 284-9005
Entity
Organization
Contact information
Practice address
45 VEREDA CORTA, SANTA FE, NM 87507-9556
(213) 284-9005
Mailing address
45 VEREDA CORTA, SANTA FE, NM 87507-9556
(213) 284-9005
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31121071
—
NM
Enumeration date
06/23/2020
Last updated
05/04/2023
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