Blomquist, Marlys
Blomquist, Marlys is an individual health care provider with primary practice located at Pvs - 1574 St. Rd. 502 , Santa Fe NM 87501. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Blomquist, Marlys can be contacted via phone (505) 455-0801.Contact Information
Primary practice address
Pvs - 1574 St. Rd. 502
Santa Fe NM 87501
Phone: (505) 455-0801
Fax: (505) 455-3023
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / School | 103TS0200X | 315117 | New Mexico |
Profile Details
| NPI number | 1992927941 |
|---|---|
| LBN Legal business name | Blomquist, Marlys |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2007 |
| Last updated | Jul 8th, 2007 - 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 | 1992927941 | NPPES |
| New Mexico | MEDICAID | 3581861 |
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