NPI 1124759006 · live from the CMS NPI Registry
3 Moon Therapy LLC
Social Worker, Clinical in Albuquerque, NM. National Provider Identifier 1124759006, active.
NPI record
| NPI | 1124759006 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 10913 Apache Ave Ne, Albuquerque, NM 87112 |
| Practice phone | 505-234-6005 |
| Mailing address | Po Box 53104, Albuquerque, NM 87153 |
| Enumerated | June 21, 2022 |
| Last updated | July 18, 2022 |
| Authorized official | Mary Duncan, Therapist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.