Provider Demographics
NPI:1528332533
Name:FIELD, JANET L (CCHT)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:FIELD
Suffix:
Gender:F
Credentials:CCHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5304 EL ENCANTO PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-6404
Mailing Address - Country:US
Mailing Address - Phone:505-797-5935
Mailing Address - Fax:
Practice Address - Street 1:3500 COMANCHE RD NE
Practice Address - Street 2:SUITE E
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4546
Practice Address - Country:US
Practice Address - Phone:505-797-5935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM02-475979-00-1OtherSTATE OF NEW MEXICO TAX ID #
39001OtherNATIONAL GUILD OF HYPNOTISTS