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>> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1184857385

Individual Registrant:
Gender: F
Not Sole Proprietor

Location and contact information for practice:
206 PORR DR  RUIDOSO, NM 88345-6713 US
Tel: 575-630-0571  Fax: --

Contact information for business:
PO BOX 28220  SANTA FE, NM 87592-8220 US
Tel: 505-471-5006  Fax: 505-820-9220

Registration Information:
NPI: 1184857385
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101Y00000XBehavioral Health & Social Service Providers

Legacy codes, insurance codes and state license numbers:



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