Provider Demographics
NPI:1295069219
Name:POKEMPNER, MERLE LEE (LPAT)
Entity type:Individual
Prefix:MS
First Name:MERLE
Middle Name:LEE
Last Name:POKEMPNER
Suffix:
Gender:F
Credentials:LPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 PAN AMERICAN FWY NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-4786
Mailing Address - Country:US
Mailing Address - Phone:505-222-0335
Mailing Address - Fax:505-222-0301
Practice Address - Street 1:3405 PAN AMERICAN FWY NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4786
Practice Address - Country:US
Practice Address - Phone:505-222-0335
Practice Address - Fax:505-222-0301
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3119101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM3119OtherNM COUNSELING AND THERAPY PRACTICE BOARD