Doctor Name: | TERRY BARSANO |
NPI Number: | 1003089079 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 0091171 |
Business Practice Address: | 1299 B Paseo Del Pueblo Norte El Prado, NM - 87529 |
Business Phone Number: | 5757587263 |
Business Fax Number: | |
Mailing Address: | Hc 74 Box 20412, EL PRADO |
State: | NM |
Postal Code: | 875299504 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/10/2008 |
NPI Last Update Date: | 04/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0091171 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |