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Priscilla Phan
Mental Health Counselor in Cannon Afb, New Mexico
NPI 1699412171

Priscilla Phan is a Mental Health Counselor based in Cannon Afb, NM and is specialized in Mental Health. Priscilla Phan practices in Cannon Afb, NM. The NPI Number for Priscilla Phan is 1699412171 and holds a License No. (New Mexico).

The current practice location address for Priscilla Phan is 224 W D.l. Ingram Ave, Cannon Afb, NM and can be reached out via phone at 575-784-1108.

Location: 224 W D.l. Ingram Ave, Cannon Afb, NM, 88101
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1699412171
Provider Name
Priscilla Phan
Credential
Provider Entity Type
Individual
Gender
Female
Address
224 W D.l. Ingram Ave, Cannon Afb, NM, 88101
Phone Number
575-784-1108
Fax Number
Provider Enumeration Date
05/17/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
224 W D.l. Ingram Ave
City
Cannon Afb
State
New Mexico
Zip
88103
Phone Number
575-784-1108
Fax Number
person
Provider Business Mailing Address Details
Address
224 W D.l. Ingram Ave
City
Cannon Afb
State
New Mexico
Zip
88103
Phone Number
575-784-1108
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
(New Mexico)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(Texas)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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