Individual
DAMIEN DEREGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
1235 8TH ST, LAS VEGAS, NM 87701-4219
(505) 426-6788
Mailing address
538 N PASEO DE ONATE, ESPANOLA, NM 87532-2618
(505) 753-7218
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CTB-2023-0759
NM
Other
Enumeration date
09/27/2023
Last updated
09/27/2023
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