Provider Demographics
NPI:1376640615
Name:GULDAN, ANA M (LPCC)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:M
Last Name:GULDAN
Suffix:
Gender:F
Credentials:LPCC
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 64
Mailing Address - Street 2:
Mailing Address - City:ALCALDE
Mailing Address - State:NM
Mailing Address - Zip Code:87511-0064
Mailing Address - Country:US
Mailing Address - Phone:505-927-6587
Mailing Address - Fax:
Practice Address - Street 1:509 W PUEBLO DR
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-2508
Practice Address - Country:US
Practice Address - Phone:505-747-3368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0109881101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health