Organization
CLEAR LAKE STUDIO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANN M SKIRVIN (OFFICE MANAGER)
(915) 345-5489
Entity
Organization
Contact information
Practice address
1925 ANITA DR, LAS CRUCES, NM 88001-2027
(915) 345-5489
(575) 541-3690
Mailing address
1925 ANITA DR, LAS CRUCES, NM 88001-2027
(915) 345-5489
(575) 541-3690
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0150641
NM
Other
Enumeration date
01/03/2015
Last updated
01/03/2015
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