| The Lighted Path Llc | |
|
14 Western Trail Dr Tijeras NM 87059-7990 | |
| (505) 508-7071 | |
| Not Available |
| Full Name | The Lighted Path Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 14 Western Trail Dr, Tijeras, New Mexico |
| Authorized Official Name and Position | Mandi Abernathy (PROVIDER) |
| Authorized Official Contact | 5055087071 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Lighted Path Llc 499 Nm 333 Unit 2468 Tijeras NM 87059-0497 Ph: (505) 508-7071 | The Lighted Path Llc 14 Western Trail Dr Tijeras NM 87059-7990 Ph: (505) 508-7071 |
| NPI Number | 1306527577 |
|---|---|
| Provider Enumeration Date | 07/28/2023 |
| Last Update Date | 07/28/2023 |
| Certification Date | 07/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306527577 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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