Provider Demographics
NPI:1275382186
Name:ESTRADA, VELIA (MA)
Entity type:Individual
Prefix:MRS
First Name:VELIA
Middle Name:
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 S TELSHOR BLVD STE Q102
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4681
Mailing Address - Country:US
Mailing Address - Phone:575-202-5167
Mailing Address - Fax:888-473-9160
Practice Address - Street 1:755 S TELSHOR BLVD STE Q102
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4681
Practice Address - Country:US
Practice Address - Phone:575-202-5167
Practice Address - Fax:888-473-9160
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2024-0330106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist