Provider Demographics
NPI:1972780849
Name:GARRIOTT-STEJSKAL, SANDRA J (MA, LPCC, LPAT)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:J
Last Name:GARRIOTT-STEJSKAL
Suffix:
Gender:F
Credentials:MA, LPCC, LPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 1ST ST NW
Mailing Address - Street 2:ALBUQUERQUE HEALTH CARE FOR THE HOMELESS
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102
Mailing Address - Country:US
Mailing Address - Phone:505-831-7815
Mailing Address - Fax:505-831-7816
Practice Address - Street 1:A.H.C.H. 1217 1ST ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102
Practice Address - Country:US
Practice Address - Phone:505-831-7815
Practice Address - Fax:505-831-7816
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2491 AND 2484101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health