Individual
MIMI MARTINE PETERS ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3908 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107-4504
(505) 639-5916
Mailing address
3908 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107-4504
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
NM
171M00000X
Case Manager/Care Coordinator
—
NM
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NM
Other
Enumeration date
04/16/2025
Last updated
04/16/2025
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