Miesem, Mary
Miesem, Mary is an individual health care provider with primary practice located at Pmg Kaseman Behavioral Medicine 1325 Wyoming Ne, Albuquerque NM 87112. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychoanalysis, which is considered as her primary health care specialty. Miesem, Mary can be contacted via phone (505) 291-5300.Contact Information
Primary practice address
Pmg Kaseman Behavioral Medicine 1325 Wyoming Ne
Albuquerque NM 87112
Phone: (505) 291-5300
Fax: (505) 291-5303
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychoanalysis | 103TP0814X | 731 | New Mexico |
Profile Details
| NPI number | 1083723308 |
|---|---|
| LBN Legal business name | Miesem, Mary |
| Credentials | LPCC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Aug 14th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083723308 | NPPES |
| New Mexico | MEDICAID | 44157339 |
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