| Active Integration Therapy, LLC | |
|
3250 Trinity Dr Ste B1 Los Alamos NM 87544-2226 | |
| (505) 695-2095 | |
| Not Available |
| Full Name | Active Integration Therapy, LLC |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3250 Trinity Dr Ste B1, Los Alamos, New Mexico |
| Authorized Official Name and Position | Michelle Wilde (MEMBER) |
| Authorized Official Contact | 5054128360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Active Integration Therapy, LLC 3250 Trinity Dr Ste B1 Los Alamos NM 87544-2226 Ph: (505) 695-2095 | Active Integration Therapy, LLC 3250 Trinity Dr Ste B1 Los Alamos NM 87544-2226 Ph: (505) 695-2095 |
| NPI Number | 1063045029 |
|---|---|
| Provider Enumeration Date | 02/18/2020 |
| Last Update Date | 02/18/2020 |
| Certification Date | 02/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063045029 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
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