Provider Demographics
NPI:1790182129
Name:KAMAL-ALDEEN, CATIANE
Entity Type:Individual
Prefix:
First Name:CATIANE
Middle Name:
Last Name:KAMAL-ALDEEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 93985
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87199-3985
Mailing Address - Country:US
Mailing Address - Phone:505-492-5964
Mailing Address - Fax:505-441-2662
Practice Address - Street 1:1740 GRANDE BLVD SE STE E-13
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1799
Practice Address - Country:US
Practice Address - Phone:505-492-5964
Practice Address - Fax:505-441-2662
Is Sole Proprietor?:No
Enumeration Date:2014-12-01
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)