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Provider Information for 1124178207


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Mrs. SHARON GUZZETTI SMAGA LMFT


Sex: Female

NPI: 1124178207
Last Updated: 2023-12-18
Certification Date: 2023-12-18

Details

NameValue
NPI1124178207
Enumeration Date2007-01-11
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 1144 PAJARITO DR
ALAMOGORDO, NM 88310-5544
United States

Phone: 575-430-3701 | Fax:
 
Primary Practice Address 1212 VERMONT AVE
ALAMOGORDO, NM 88310-6343
United States

Phone: 505-439-3270 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNM50851233
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 106H00000X - Marriage & Family Therapist NM0110501