Basic Information
Provider Information
NPI: 1962684951
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAIZ
FirstName: FRANK
MiddleName: LAWRENCE
NamePrefix: MR.
NameSuffix:  
Credential: LPCC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2500 WISCONSIN ST NE
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871103754
CountryCode: US
TelephoneNumber: 5052991521
FaxNumber:  
Practice Location
Address1: 1001 YALE NE
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871310001
CountryCode: US
TelephoneNumber: 5052722190
FaxNumber: 5052723466
Other Information
ProviderEnumerationDate: 11/30/2007
LastUpdateDate: 01/29/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X0145051NMY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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