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CARMALITA BACA

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1114400017

Individual Registrant:
 CARMALITA  BACA 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
711 BARNES AVE  LA JUNTA, CO 81050-2138 US
Tel: 800-511-5446  Fax: --

Contact information for business:
711 BARNES AVE  LA JUNTA, CO 81050-2138 US
Tel: 800-511-5446  Fax: --

Registration Information:
NPI: 1114400017
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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