Samford, Dezaree Tamara Lee

Samford, Dezaree Tamara Lee is an individual health care provider with primary practice located at 2413 Yale Ave , Alamogordo NM 88310-4536. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Samford, Dezaree Tamara Lee can be contacted via phone (575) 740-6873.

Contact Information

Primary practice address
2413 Yale Ave Alamogordo NM 88310-4536
Phone: (575) 740-6873
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1104184266
LBN Legal business name Samford, Dezaree Tamara Lee
Credentials INTER
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2012
Last updated Aug 23rd, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104184266 NPPES
New Mexico MEDICAID 18677037

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