Provider Demographics
NPI:1124389952
Name:TAFOYA, LETICIA (MFT)
Entity type:Individual
Prefix:
First Name:LETICIA
Middle Name:
Last Name:TAFOYA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 PENNSYLVANIA ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3641
Mailing Address - Country:US
Mailing Address - Phone:505-379-4100
Mailing Address - Fax:
Practice Address - Street 1:2725 PENNSYLVANIA ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-3641
Practice Address - Country:US
Practice Address - Phone:505-379-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist