Provider Demographics
NPI:1669058764
Name:RIBE, ISABEL CLAIRE
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:CLAIRE
Last Name:RIBE
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 1:1629 STATE ROAD 502
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87506-2691
Mailing Address - Country:US
Mailing Address - Phone:505-819-9966
Mailing Address - Fax:
Practice Address - Street 1:1213 MERCANTILE RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-7231
Practice Address - Country:US
Practice Address - Phone:505-303-4195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-20
Last Update Date:2021-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCMH0207141101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health