Organization Name: | A GUIDING PATH, LLC |
NPI Number: | 1235586967 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRENDEN E DIX (OWNER/CLINICIAN) |
Mailing Address: | 6666 4th St Nw Los Ranchos |
State: | NM US |
Postal Code: | 871076144 |
Phone Number: | 5059775376 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2016 |
NPI Last Update Date: | 05/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0181451 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |