Agolia, Mary Ellen
Agolia, Mary Ellen is an sole proprietor health care provider with primary practice located at 20 Cottage Row Unit B, High Rolls Mountain Park NM 88325-9010. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Agolia, Mary Ellen can be contacted via phone (575) 430-4115.Contact Information
Primary practice address
20 Cottage Row Unit B
High Rolls Mountain Park NM 88325-9010
Phone: (575) 430-4115
Fax: (866) 561-1508
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 1188 | New Mexico |
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | M0432 | New Mexico |
Profile Details
| NPI number | 1598837841 |
|---|---|
| LBN Legal business name | Agolia, Mary Ellen |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 14th, 2006 |
| Last updated | Mar 21st, 2021 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598837841 | NPPES |
| New Mexico | MEDICAID | N3745 |
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