Organization
LIFESPAN WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIKA K JOHNSON-JIMENEZ PH.D. (PSYCHOLOGIST)
(505) 386-0063
Entity
Organization
Contact information
Practice address
8200 MOUNTAIN RD NE STE 101, ALBUQUERQUE, NM 87110-7835
(505) 385-0161
(505) 544-4648
Mailing address
8200 MOUNTAIN RD NE STE 101, ALBUQUERQUE, NM 87110-7835
(505) 385-0161
(505) 544-4648
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4880277
NM
Other
Enumeration date
11/01/2014
Last updated
07/21/2022
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