Provider Demographics
NPI:1114280534
Name:AUR, EMILIA ANDERSON (LPCC)
Entity Type:Individual
Prefix:
First Name:EMILIA
Middle Name:ANDERSON
Last Name:AUR
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:EMILIA
Other - Middle Name:AUR
Other - Last Name:NORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4013 SIMMS AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-4374
Mailing Address - Country:US
Mailing Address - Phone:505-603-6787
Mailing Address - Fax:
Practice Address - Street 1:4013 SIMMS AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-4374
Practice Address - Country:US
Practice Address - Phone:505-603-6787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0167161101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health