Provider Demographics
NPI:1447625678
Name:HUMADA-LUDEKE, AMALIA (LMFT)
Entity type:Individual
Prefix:DR
First Name:AMALIA
Middle Name:
Last Name:HUMADA-LUDEKE
Suffix:
Gender:F
Credentials:LMFT
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 5040
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88062-5040
Mailing Address - Country:US
Mailing Address - Phone:575-956-6135
Mailing Address - Fax:575-956-6204
Practice Address - Street 1:530 HIGHWAY 180 W
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-4400
Practice Address - Country:US
Practice Address - Phone:575-956-6135
Practice Address - Fax:575-956-6204
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0190651106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist