Basic Information
| Provider Information | |||||||||
| NPI: | 1992073217 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MULDEZ | ||||||||
| FirstName: | FRANCIS 'CISCO' | ||||||||
| MiddleName: | ARTHUR | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2441 CABEZON BLVD SE | ||||||||
| Address2: | |||||||||
| City: | RIO RANCHO | ||||||||
| State: | NM | ||||||||
| PostalCode: | 87124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5057171155 | ||||||||
| FaxNumber: | 5057171473 | ||||||||
| Practice Location | |||||||||
| Address1: | 2112 MAIN STREET NE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | LOS LUNAS | ||||||||
| State: | NM | ||||||||
| PostalCode: | 87031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5059165900 | ||||||||
| FaxNumber: | 5059165901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2011 | ||||||||
| LastUpdateDate: | 09/11/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 0106531 | NM | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101Y00000X | NM | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.