Basic Information
| Provider Information | |||||||||
| NPI: | 1851678734 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TENORIO | ||||||||
| FirstName: | AMBER | ||||||||
| MiddleName: | JOY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 28220 | ||||||||
| Address2: | |||||||||
| City: | SANTA FE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 875928220 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 700 E ROOSEVELT AVE STE 18 | ||||||||
| Address2: | |||||||||
| City: | GRANTS | ||||||||
| State: | NM | ||||||||
| PostalCode: | 870202178 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5058761890 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2011 | ||||||||
| LastUpdateDate: | 11/07/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 0121591 | NM | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.