Organization · NPI-2

Azhar Integrative Psychiatry LLC Dba Wildkind Psychiatry

Clinic/Center, Adult Mental Health · Santa Fe, NM

NPI number1356249122
StatusActive
Last updated in NPPESOct 29, 2026

Details

NPI
1356249122
Entity type
Organization (NPI-2)
Legal business name
Azhar Integrative Psychiatry LLC Dba Wildkind Psychiatry
Organization subpart
No
Enumeration date
Oct 29, 2026
Certification date
Oct 29, 2026
Last updated
Oct 29, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0850X Clinic/Center, Adult Mental Health––Yes

Practice location

204 Navajo Dr
Santa Fe, NM 87505-3823

Phone 505-490-2558

Mailing address

204 Navajo Dr
Santa Fe, NM 87505-3823

Phone 505-490-2558

Authorized official

Rahma Coburn
Owner, Pmhnp
5054902558

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